Repair Of Skin And Nerve Defects Of Finger With Tibial Free Flap Of The Second Toe

Objective:To report a surgical method and clinical efficacy of repair of skin and softtissue defects associated with the artery and nerve defects of finger by free flap from thetibial side of the second toe.Methods:10cases (10fingers) of finger skin and soft tissue defects associated withthe artery and nerve defects were treated with free flap from the tibial side of the secondtoe.9cases were in emergency.The free flap of the second toe was used to cover the defectsof the skin and soft tissue.The artery and nerve of the flap’s axis were bridged the defectsof digital proper artery and nerve.The area of skin and soft tissue defects ranged from5.0cm x2.0cm to2.0cm x1.5cm.The average area of flap was3.5cm x1.7cm.The length ofthe arterial and nerve defect ranged from5.0cm to2.0cm(average,3.5cm).The donor sitedefect of the second toe was covered by full thickness skin graft from the ipsilateral leg.Results:All flaps survived.Primary wound healing was observed in all.10cases hadfollowed up for1to3years(average,15months).The two-point discrimination of thefingertip was6～10mm,an average of8mm.Two point discrimination of the flap recoveredto6-10mm(average,9mm).All cases were followed form6to36months (mean15months).Primary healing occurred in all the foot donors,without scar contracture andulceration.It did not disturb dressing shoes and walking.Conclusions: It is a reliable approach for soft—tissue coverage of the finger usingfree flap from the tibial side of the second toe. It can repair good appearance and functionof the finger.