Second toe microsurgical free-flap for aesthetic and sensory reconstruction of palmar soft tissue defects of fingers

SummaryObjectivesTo illustrate the surgical methods and clinical efficacy of microsurgical free-flaps obtained from second toe for the reconstruction of palmar soft-tissue defect of fingers.MethodsWe enrolled 22 patients (13 men and 9 women), who received second toe free-flap for 22 finger defects between August 2007 and July 2013. The average age was 35 years (range, 18–62 years). The average size of flap was 2.7 cm × 2.0 cm (range, 1.5 cm × 1.5 cm–3.5 cm × 2.5 cm).ResultsAll flaps survived well without any complications. Follow-up period ranged from 8 to 30 months (mean 15 months). The Visual Analog Scale for flap appearance (VAS flap) was ranged from 8 to 10 (average, 9.5). Based on the CISS questionnaires, 6 cases had mild cold intolerance. The average value of Michigan Hand Outcome Questionnaire (MHOQ) scoring for overall hand function was 8 (range, 5–13). The sensibility outcomes in 10 patients who underwent nerve repair were satisfactory. Average value of static two point discrimination (2PD) was 6.4 mm (range, 4–10 mm) and SWM test was 3.45 (range 2.83–4.12).ConclusionsSecond toe free micro-flap is a very useful and reliable alternative for the reconstruction of palmer soft-tissue defect of fingers.Level of Evidence: IV.