Reconstruction of lateral finger soft tissue defects using tibial side free flap from the second toe with digital artery and nerve anastomosis

Abstract

Objective To investigate the surgical procedure and treatment outcomes of repairing soft tissue defects of the finger accompanied by proper digital artery and nerve defects.Methods Eight patients with soft tissue defects on the hteral side of the proximal and middle phalanx of the fingers accompanied by proper digital artery and nerve defects were treated by the second toe tibial side skin flap.The defects of the proper digital artery and nerve were bridged at the same time.The sizes of the soft tissue defects varied from 4.0 cm×1.5 cm to 2.0 cm × 1.0 cm.The sizes of skin flaps harvested varied from 4.2 cm × 1.8 cm to 2.5 cm ×1.5 cm.The average length of the proper digital artery and nerve defects was 2.4 cm,ranging from 1.0 to 4.0 cm.Results All flaps survived.Postoperatively the patients were follow-up for 6 to 36 months with an average ef 15 months.The contour of the repaired fingers was good.The fingertips were warm,without cold intolerance.The Allen test was negative for all the fingers.2-PD of the repaired side of the fingertip averaged 8mm,ranging from 6 to 15 mm.The donor sites healed well.Conclusion It is an ideal method to repair lateral soft tissue defects of the fingers using tibial flap from the second toe with the defects of the proper digital artery and nerve bridged.This method can restore the appearance,blood supply and sensation of the injured finger. Key words: Finger injuries; Surgical flaps; Transplantation; Toes