Full-Length Finger Reconstruction for Proximal Amputation With Expanded Wraparound Great Toe Flap and Vascularized Second Toe Joint

Sun, Wenjuan; Chen, Chao; Wang, Zengtao; Qiu, Shenqiang; Zhang, Lishan; Ding, Zihai; Zhang, Shizhen

doi:10.1097/sap.0000000000000683

Annals of Plastic Surgery

2016

DOI: 10.1097/sap.0000000000000683

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Full-Length Finger Reconstruction for Proximal Amputation With Expanded Wraparound Great Toe Flap and Vascularized Second Toe Joint

Wenjuan Sun

Chao Chen

Zengtao Wang³

et al.

Abstract: The full-length finger reconstruction procedure allows for construction of natural-appearing full-length fingers with normal PIP joint positioning and a near-normal functional recovery for proximal digital amputation. The operation is technically complex and time consuming and demands a skilled operator for successful outcomes.

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Cited by 8 publications

(1 citation statement)

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“…1 Nevertheless, in more proximal avulsion, the finger requires more. 2 A second toe tibial hemipulp flap with a common pedicle would be harvested for proximal sensate resurfacing of the palmar digit. 3 Incorporating a skin paddle from the dorsum of the foot with the composite flap allows more skin for proximal coverage of the dorsal digit.…”

mentioning

confidence: 99%

Combined great toe dorsal nail-skin flap and medial plantar flap for reconstruction of degloved finger loss

Lin

Zhou

Huang

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Historically, the degloved finger with the total loss of nails and skin has been resurfaced in two stages. Furthermore, proximal finger amputation requires an additional bone-tendon graft and an expanded great toe wraparound flap transfer for better outcomes. This article recommends a novel strategy to address these problems in a single stage using a dorsal nail-skin flap and medial plantar artery perforator flap. Methods: From March of 2015 to June of 2018, nine procedures were performed to resurface with skin loss to the metacarpophalangeal joint level, and three amputated fingers were reconstructed with an extra bone-joint-tendon graft simultaneously. The dorsal great toe donor was covered with a thin groin flap, and the medial plantar site was covered with a full-thickness skin graft. A standardized assessment of outcome in terms of sensory, functional, and aesthetic performance was completed. Results: All flaps survived. The contour and length of the reconstructed digits were comparable with the contralateral finger. The mean static two-point discrimination was 11.0 mm (range, 9.0 to 14.0 mm). The average score of the Disabilities of the Arm, Shoulder, and Hand questionnaire and Michigan Hand Outcomes Questionnaire were 2.5 (range, 0 to 5) and 90.1 (range, 82 to 96), respectively. The mean Foot and Ankle Disability Index score was 95.6 (range, 93 to 99). At the last follow-up, the functional and aesthetic outcomes, and the restored sensation, were satisfactory for all fingers. Conclusion: This strategy may provide an alternative for selected patients seeking cosmetic resurfacing and functional reconstruction, preserving a weight-bearing plantar area with less morbidity. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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mentioning

confidence: 99%

Combined great toe dorsal nail-skin flap and medial plantar flap for reconstruction of degloved finger loss

Lin

Zhou

Huang

et al. 2023

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

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Utility of the Digital Fillet Flap

Masadeh

Rodriguez

Dierksheide

et al. 2020

Clinics in Podiatric Medicine and Surgery

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Exploring New Frontiers of Microsurgery

Wang

Zheng

Zhu

et al. 2017

Clinics in Plastic Surgery

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Full-Length Finger Reconstruction for Proximal Amputation With Expanded Wraparound Great Toe Flap and Vascularized Second Toe Joint

Cited by 8 publications

References 20 publications

Combined great toe dorsal nail-skin flap and medial plantar flap for reconstruction of degloved finger loss

Combined great toe dorsal nail-skin flap and medial plantar flap for reconstruction of degloved finger loss

Utility of the Digital Fillet Flap

Exploring New Frontiers of Microsurgery

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