Finger Reconstruction with a Free Neurovascular Wrap-around Flap from the Big Toe

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Journal of the Korean Society for Surgery of the Hand 1999;4(2):169-178.
Published online January 1, 1999.

Soo Bong Hahn,Eung Shick Kang,Ho Jung Kang,Hong Jun Park

Wrap-around 유리 피부판을 이용한 수지의 재건

한수봉,강응식,강호정,박홍준

Abstract

From 1983 to 1998, 16 cases of finger reconstruction with a free neurovascular wrap-around flap from big toe were performed. Fourteen cases were successful and excellent functional and cosmetic results were achieved. Pinch power was 51% of unaffected normal hand and two-point discrimination was 9.2mm. The bone resorption was 13% of the initial bone graft width and 9% of that in length. There were no complications such as fracture of grafted bone, nonunion, pulp dislodgement. This procedure provided length, stability and adequate sensibility for a functional pinch and grasp. The sensory return to wrap-around flap on the thumb is often greater than for the same area on the opposite foot. The donor site of the wrap-around flap is acceptable esthetically and functionally in open-toed shoe styles worn by young woman. Finger reconstruction with a wrap-around flap from the big toe gives excellent cosmetic and functional results in cases of amputation at the level of the metacarpo-phalangeal joints or distal to it. In addition, in cases of the avulsion injuries of fingers and reconstruction of soft tissue defect after tumor excision, this procedure could be an excellent choice of treatment.

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