A nonreplantable complete degloving injury to the small finger of a young woman was treated with the immediate microsurgical transfer of a second-toe wrap-around flap. One year after the operation, the donor foot was free of symptoms, and the reconstructed finger had an excellent cosmetic appearance, a range of motion of 0/90 degrees at both the metacarpophalangeal and the proximal interphalangeal joints, and a two-point discrimination of 6 mm. In selected patients, when the degloved skin envelope cannot be revascularized and when the skeletal and tendinous units are still intact, an immediate second-toe wrap-around flap may be a good alternative to amputation.
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http://dx.doi.org/10.1016/0363-5023(92)90322-g | DOI Listing |
Plast Reconstr Surg Glob Open
August 2024
From the Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Loss of the thumb secondary to trauma leads to significant disability due to the digit contributing 40% of overall hand function. Toe-to-thumb transfer has been a well-studied reconstructive method as a means to restore function after thumb amputation. First described in 1969 by Cobbett and colleagues, toe-to-thumb transfers have undergone several modifications in technique to better improve functional and aesthetic outcomes, including toe wrap-around flaps, trimmed great toe transfer, and second toe transfers.
View Article and Find Full Text PDFJ Hand Surg Eur Vol
January 2025
Department of Hand Surgery, Wuxi No. 9 People's Hospital Affiliated to Soochow University, Wuxi Hand Surgery Hospital, China.
This study compared the clinical outcomes of tibial-sided digital artery pedicled flap from the second toe versus full-thickness skin grafting to repair great toe defects after wrap-around flap transfers. The pedicled flap resulted in better pain scores and aesthetic outcomes.
View Article and Find Full Text PDFJ Hand Surg Eur Vol
October 2023
Department of Hand surgery, Wuxi NO. 9 People's Hospital affiliated to Soochow University, Wuxi Hand Surgery Hospital, China.
We report the results of using a fibula-sided digital artery pedicled flap from the great toe to cover the second toe free flap donor site, which avoids delayed wound healing, and prevents pain and skin ulceration. This study included 15 patients who had second toe wrap-around free flaps to reconstruct thumb and finger defects. All 15 pedicled flaps used to cover the defect healed uneventfully.
View Article and Find Full Text PDFJ Plast Reconstr Aesthet Surg
September 2021
Department of Hand and Foot Microsurgery, Guigang City People's Hospital, No.1 Zhongshan ZhongLu, Guigang, Guangxi Zhuang Autonomous Region 537100, China. Electronic address:
Background: Computed tomography angiography (CTA) has become a widely used imaging modality in vascular surgery. The first web arterial branches of the foot are significant for surgical planning of the donor site for thumb reconstruction.
Methods: We retrospectively analysed 30 thumb reconstructions with free second toe/great toe wrap-around flap transfer, performed between January 2016 and January 2019.
J Plast Surg Hand Surg
December 2018
a Department of Orthopaedic Surgery , Nara Medical University, Kashihara , Japan.
Objective: Toe-to-hand transplantation is a reliable procedure that replaces like-with-like in cases of a lost thumb or finger. The aim of this study is to investigate the effects of toe transplantation on patients from the perspectives of quality of life (QOL) and disability.
Methods: Ten patients with traumatic amputation of a digit underwent reconstruction with toe transplantation.
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