Treatment Of Finger Degloving Injury By Combined Transplantation Of Wrap-around And Tibial Flaps From The Second Toes:A Follow-up Study

Objective:To evaluate the outcomes of the reconstruction of degloved fingers with combined transplantation of wrap-around and tibial flaps from the second toes.Methods:Between 2010 and 2017,twenty-one patients with finger degloving injuries were treated with combined transplantation of wrap-around and tibial flaps from the second toes in our hospital.These patients were follow-up for 1 to 7 years.The contour and function of the reconstructed fingers were analyzed with Evaluation Criteria for Function of Reconstructed Thumb and Finger issued by the Hand Surgery Society of the Chinese Medical Association and the Michigan Hand Outcome Questionnaire(MHQ),respectively.The Maryland Foot Score was used to evaluate the overall outcomes of the donor sites.Results:The transplanted flaps in all cases survived with no atrophy.The reconstructed fingers looks good,with nails grew well and the sensory function of finger pulps and the protective sensation in the finger back recovered well.The functional evaluation with the Evaluation Criteria issued by Chinese Medical Association Hand Surgery Society showed that all reconstructed fingers recovered well,among 21 cases,15 were excellent,5 were good and 1 was fair.The MHQ analysis showed that patients were satisfied with the outcome.The foot donor site healed without scarring.Donor site surgery had no effect on walking.Evaluation of donor site by the Maryland foot score showed 18 excellent and 3 good.Conclusion:Reconstruction of degloved fingers with combined transplantation of wrap-around and tibial flaps from the second toes results in excellent contour and functional outcome.The surgery has no significant effect on the function of donor toes.