Composite toe transfer combined with flap to reconstruct thumb defect

Abstract

Objective To explore the effectiveness of reconstructing thumb by big toe wrap-around flap combined with metatarsophalangeal joint and tendon transfer from the second toe and flrst web reconstruction by flaps.Methods Five cases of type Ⅴ thumb defect were treated from March 2006 to May 2010 by composite toe transfer to reconstruct the thumb and by a free or pedicled flap to reconstruct the flrst web.Postoperative results were evaluated using the criteria for function of reconstructed thumb and fingers issued by the Hand Surgery Society of the Chinese Medical Association.Results Four cases were follow-up for 12 to 60 months.The results were graded as excellent in 1 case,good in 2 cases and fair in 1 case.Function and form of the reconstructed thumb and first web were satisfactory.The donor foot maintained normal gait.There were no complications and pain.Conclusion Composite toe transfer combined with flap transfer can achieve good clinical outcomes in reconstruction of type Ⅴ thumb defects.It is indicated for young patients who have high expectation on appearance of the thumb. Key words: Tissue transplantation; Finger injuries; Complex tissue flap