Hand reconstruction by transplanting the fostered residual finger and second toe which share the same blood supply system

Abstract

Objective To investigate the methods and results of hand reconstruction by transplanting the fostered residual finger and the second toe, which share the same blood supply system. Methods From January, 2014 to January, 2016, 3 cases with destructive hand injuries in our hospital; and debridement was performed in one session during the early stage of trauma, with skin grafting to cover the wrist stump and foster the residual finger to a branch of the dorsalis pedis artery. The first dorsal metatarsal artery around the toe web was identified and then grad-ually isolated proximally with dissection of the branches of the dorsalis pedis artery supplying the fostered finger until the convergence of the two blood vessels. Then , reconstructed hand by residual finger and combined second toe transplantation. Results After a follow-up period of 3 months to 2 years, the reconstructed hand had a good appearance and was able to complete basic mundane actions. The function of the limb was restored to a large extent and the patient was satisfied with the reconstructed hand. Conclusion Transfer of a fostered residual finger and combined second toe which have the same blood supply system for hand reconstruction as a new method need to anasto-mose only one set of arteries, and it is feasible with the good appearance and function of the reconstructed hand. Key words: Destructive hand injuries; Foster finger; Second toe; Reconstruction; Combined transfer