Free second toe transplantation with the first dorsal metatarsal artery flap in reconstruction of thumb and repair of adjacent finger wound

Abstract

Objective To explore the surgical method and clinical effects of free second toe transplantation with the first dorsal metatarsal artery flap in reconstruction of thumb and repair of adjacent finger wound. Methods From June 2010 to June 2015, 9 cases of thumb defect and adjacent finger soft tissue defects were treated using free second toe transplantation with the first dorsal metatarsal artery flap. The area of the first dorsal metatarsal artery flap ranged from 3.3 cm×2.0 cm to 5.2 cm×3.0 cm. Free skin grafts were used to repair donor site. Results Postoperatively tension blister at the distal end of the flap occurred in 1 case which were healed after removal of stitches and change of dressing. Other reconstructed fingers, flaps and skin grafts achieved primary healing. All the patients were follow-up for 6 to 32 months with an average of 15 months. All the flaps presented good appearance and elasticity with soft texture. The appearance and function of the reconstructed thumbs were good. There was no obvious effect on foot load walking. No skin ulcer occurred in donor site. Conclusion Free second toe transplantation with the first dorsal metatarsal artery flap in reconstruction of thumb and repair of adjacent finger wound is an ideal method for repairing due to the reliable blood supply, safe operation and accordance to repair principle. Key words: Surgical flaps; Microsurgery; Tissue defects; Repair