Repairation of composite distal soft tissue defect of thumb and finger with mini toenail flap

Abstract

Objective To introduce the repairation procedure of composite distal soft tissue defect of thumb and finger with mini toenail flap. Methods From June, 2015 to June, 2018, 7 cases with composite tissue defect at 7 distal fingers, including 5 thumbs, 1 index finger and 1 middle finger, were reconstructed with mini toenail flap transfer. The flap sizes which were raised during the operation ranged from 4.5 cm×3.0 cm-3.0 cm×1.5 cm. The donor sites were covered by toe phalanx shortening, V-Y advancement flap and local pedicle flap. Microsurgical routine treatment was made after the operation, and followed-up regularly. Results Seven flaps of 7 cases completely survived without any necrosis. All the wounds at the donor sites healed well. All patients were followed-up for 6-36 months. The motive, sensor and cosmetic result were satisfied. In sensory function, the two-point discrimination distance could restore to be 4-6 mm. Conclusion The mini toenail flap transfer is a reliable and suggested method. It can anatomically restored the distal digit sensor function with cosmetic contour, and regain the motive, sensory function and satisfied cosmetic appearance. Key words: Toenail flap; Toe transplantation; Finger; Repairation; Distal finger defect