Emergency repair of the soft tissue defects of finger by transplantation of flow-through composite tissue flap with the joint from the second toe

Abstract

Objective To evaluate the clinical efficacy of transplantation of flow-through composite tissue flap with the joint from the second toe for emergency repair of the soft tissue defects of finger. Methods From March 2009 to February 2016, 12 cases (15 fingers) of finger composite tissue defects with proximal interphalangeal joint defects were treated by transplantation of flow-through composite tissue flap with the joint from the second toe. The area of the composite tissue flap was 15 mm×10 mm to 40 mm×35 mm. The length of the bone joint was 20 to 42 mm with an average of 28 mm. The length of the proper digital artery was 26 to 38 mm with an average of 30 mm. The length of the proper digital nerve was 22 to 40 mm with an average of 28 mm. Results All the composite flaps of the fingers survived and the wounds achieved primary healing. The follow-up period ranged from 8 to 30 months. The transplanted joints were healed without any degenerative changes or nonunion. Except for 2 cases with mild hypoextension, rest joints were all well-moved. The flexion of the proximal interphalangeal joint of the fingers ranged from 40° to 90° with an average of 65°, and the extension ranged from -10° to 10°. The blood supply of the finger was good, and the two-point discrimination of the fingertip was 6 to 12 mm. The patients were satisfied with the appearance and function of the fingers. According to the hand function evaluation standard issued by the Hand Surgery Society of the Chinese Medical Association, the results were excellent in 5 fingers, good in 8 fingers, fair in 1 finger and poor in 1 finger. Conclusion The application of flow-through composite tissue flap of the second toe with interphalangeal joint transplantation for emergency repair of the finger complex tissue defects with joint defects can restore good finger joint function, and reconstruct the blood supply and sensation of the distal finger. It can meet the basic living requirement of the patient, which is one of the ideal methods to repair complicated injuries of the finger. Key words: Finger injuries; Surgical flaps; Joint transplantation; Composite tissue