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Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers

  • Cho, Yong Jin (Department of Plastic and Reconstructive Surgery, Kwang-Myung Sung-Ae General Hospital) ;
  • Roh, Si Young (Department of Plastic and Reconstructive Surgery, Kwang-Myung Sung-Ae General Hospital) ;
  • Kim, Jin Soo (Department of Plastic and Reconstructive Surgery, Kwang-Myung Sung-Ae General Hospital) ;
  • Lee, Dong Chul (Department of Plastic and Reconstructive Surgery, Kwang-Myung Sung-Ae General Hospital) ;
  • Yang, Jae Won (Department of Plastic and Reconstructive Surgery, Kwang-Myung Sung-Ae General Hospital)
  • Received : 2012.12.01
  • Accepted : 2013.02.01
  • Published : 2013.05.15

Abstract

Background The reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps. Methods A single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years) with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases) followed by amputations (3 cases) and a single case of burn injury. Half of the indications (6 cases) were for soft-tissue defects with the other half for scar contracture. Results All of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series. Conclusions Flexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.

Keywords

References

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Cited by

  1. Palmar Hand Wound Coverage with the Free Flaps vol.23, pp.2, 2013, https://doi.org/10.15596/arms.2014.23.2.45
  2. Full-Thickness Skin Grafting with De-Epithelization of the Wound Margin for Finger Defects with Bone or Tendon Exposure vol.42, pp.3, 2013, https://doi.org/10.5999/aps.2015.42.3.334
  3. Free toe pulp flap for finger pulp and volar defect reconstruction vol.49, pp.2, 2016, https://doi.org/10.4103/0970-0358.191319