Repair of Minor Tissue Defect in Hand by Transfer of Free Tissue Flap from the Toe

Abstract

Background: <br/> <br/><span style="font-family: ArialMT; font-size: xx-small;"><span style="font-family: ArialMT; font-size: xx-small;">To introduce our experience of using the free neurovascular flap from great and second toe.</span></span> <br/>Methods: <br/> <br/><span style="font-family: ArialMT; font-size: xx-small;"><span style="font-family: ArialMT; font-size: xx-small;">Thirteen patients (fifteen fingers) sought surgical treatment for soft tissue defects of the hand at our medical</span></span> <br/>institutin between March 2006 and September 2009. In two patients, fibular side skin-nail flaps of great toe were <br/>applied to cover the dorsal defect of distal thumb. In twelve, in the treatment of pulp defect of finger with fibular side <br/>flap of great toe or tibial side flap of second toe. In one, in the treatment of defect of distal middle with composite flap <br/>with distal digital bone of second toe. <br/>Results: <br/> <br/><span style="font-family: ArialMT; font-size: xx-small;"><span style="font-family: ArialMT; font-size: xx-small;">All flaps were survived. The average subjective satisfaction score was 8.08 (range 4-10). Nine patients</span></span> <br/>(69%) experienced cold intolerance, and 2 patients (15%) dysesthesia. The Semmes-Weinstein sensitivity score was <br/>between 3.47and 4.72 on the flap, and 0-4.18 on the donor site. The mean two-point discrimination was 6.8 mm (range <br/>4-12). Grip strength was 10% less than in the unaffected hand. The proximal interphalangeal mobility loss was less <br/>than 15 degrees. <br/>Conclusions: <br/> <br/><span style="font-family: ArialMT; font-size: xx-small;"><span style="font-family: ArialMT; font-size: xx-small;">Our results indicated that these free flaps from toe are useful for patients with a small soft-tissue</span></span> <br/>defect in hand.