Anatomical bases of the second toe composite dorsal flap for simultaneous skin defect coverage and tendinous reconstruction of the dorsal aspect of the fingers

Wavreille, G.; Cassio, Jean-Baptiste; Chantelot, Christophe; Marès, Olivier; Guinand, R.; Fontaine, C.

doi:10.1016/j.bjps.2007.03.016

Cited by 15 publications

(13 citation statements)

References 18 publications

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“…Disadvantages include the complex surgical procedures, the need for microsurgical technique, the risk of anastomosis failure, possible anatomic variation, 10 2 or more staged procedures, and the result of a small nail and hairy pulp coverage. In addition, the patient requires hospitalization for 7 to 10 days, which may be extravagant use of health care resources in the days of budget constraints.…”

Section: Discussionmentioning

confidence: 98%

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Reconstruction of Distally Degloved Fingers With a Cross-Finger Flap and a Composite-Free Flap From the Dorsum of the Second Toe

Wang

Jiang

et al. 2012

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 98%

“…As described by Wavreille et al, 10 the composite flap including the nailbed was designed on the dorsum of the second toe ( Fig. 3A) distal to the metatarsophalangeal joint line.…”

Section: Surgical Techniquementioning

confidence: 99%

Reconstruction of Distally Degloved Fingers With a Cross-Finger Flap and a Composite-Free Flap From the Dorsum of the Second Toe

Wang

Jiang

et al. 2012

The Journal of Hand Surgery

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“…However, if complete digital skin and nail avulsion from proximal metacarpophalangeal joint level occurs in fingers, a wrap-around flap may not be sufficient to cover the proximal palm of the finger due to larger size of defect. According to the previous anatomical studies, 17,18 the second toe medial flap based on the same vessel pedicle of the great toe wrap-around flap can be combined for cover the remaining palmar defect.…”

Section: Discussionmentioning

confidence: 99%

Free great toe wrap‐around flap combined with second toe medial flap for reconstruction of completely degloved fingers

Rui¹,

Mi²,

Shi³

et al. 2010

Microsurgery

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Surgical procedure of great toe wrap-around flap combined with second toe medial flap free transfer for reconstructing completely degloved fingers was introduced. The treatment outcomes were evaluated. 10 fingers in 7 cases were involved in this series. The great toe wrap-around flap with dorsalis pedis skin covered the dorsal and most palmar side of the injured finger. The second toe medial flap covered the proximal palmar portion of the finger. The combined flap was revascularized with nerve repair. Rehabilitation started two weeks postoperatively. All flaps survived except one was partial failure due to distal phalange necrosis. Recipient areas achieved primary wound healing in 9 fingers. Skin graft at donor site achieved primary survival except delayed healing in one case. All patients were followed-up from 34 to 76 months. The appearance of reconstructed fingers was satisfactory. Nail growth well except that one nail was the atrophic and another was defect. Range of active motion in the metacarpophalangeal joint was from 60° to 80° and the proximal interphalange joint was 40° to 70°. Two-point discrimination was between 8 mm and 12 mm. All patients walked with no interference. There was no pain and no swelling at donor site. According to the results, this procedure is recommended to reconstruct total degolving finger which has intact phalanges and tendons.

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“…20 Local reconstruction techniques for covering digital defects are well established. 21Y23 However, if multiple digits are involved, or the size of the defect is extensive with composite tissue loss, such options for soft tissue reconstruction may not be ideal or possible.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

Yan¹,

Fan²,

Zhang³

et al. 2013

Annals of Plastic Surgery

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Coverage of the dorsal aspect of the fingers is difficult, especially when the defect is large and multiple digits are involved with composite tissue loss and very few conventional flaps are suitable in dealing with such situation. The purpose of this study was to present our experience of reconstruction of the large dorsal digital defects with the arterialized venous flap (AVF) and evaluate its merits and demerits in this clinical setting with a comprehensive review of literature. From August 2008 to December 2010, 7 composite palmaris longus venous flaps and 5 AVFs were used in the reconstruction of extensive dorsal digital injuries in 8 patients, and a comprehensive review of literature regarding the reconstruction of dorsal digital defects with AVFs was carried out. All the flaps survived completely. The outcomes were very satisfactory for functional recovery, aesthetic appearance, and sensation restoration at an average follow-up of 11.8 months; the literature review also revealed the similar results. On the basis of our experience and literature review, AVFs are reliable and good candidates for resurfacing large dorsal digital defects when local flaps are not available or insufficient for coverage. Composite AVF with palmaris longus tendon is an optimal choice for 1-stage reconstruction of dorsal composite finger injuries.

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Anatomical bases of the second toe composite dorsal flap for simultaneous skin defect coverage and tendinous reconstruction of the dorsal aspect of the fingers

Cited by 15 publications

References 18 publications

Reconstruction of Distally Degloved Fingers With a Cross-Finger Flap and a Composite-Free Flap From the Dorsum of the Second Toe

Reconstruction of Distally Degloved Fingers With a Cross-Finger Flap and a Composite-Free Flap From the Dorsum of the Second Toe

Free great toe wrap‐around flap combined with second toe medial flap for reconstruction of completely degloved fingers

Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

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