gms | German Medical Science

Objectives/Interrogation: To evaluate the outcome of the procedure of using the free flap vascularized by the fibular side of the great toe to treat finger dorsal skin defect

Methods: From June 2013 to August 2016, 18 patients with finger skin defects were repaired by modified fibular side pulp flap of great toe. The portable Doppler was used to detect and identify the artery perforator from the fibular side skin of great toe before the operation. The design area of the modified fibular side pulp flap of great toe is between the traditional dorsal flap of foot and the fibular side pulp of the toe. The area of the flaps ranged from 3.2 cm × 2.4 cm to 7.6 cm × 2.8 cm.

Results: All of the 18 flaps survived at the last office visit, and the wounds in the donor and recipient areas healed well. In 18 patients in this group, 4 cases of skin flaps appeared vesicles within 1 to 2 days after operation. The epidermis of vesicles was dislocated after 1 month. There was no obvious different appearance between graft skin flap and normal skin tissue at last.The follow-up period ranged from 7 to 16 months. There was no pigmentation on the surface of the flap, The texture, shape and function of the finger were satisfactory. Two points of flaps discrimination restored 4 to 6 mm, sensory function of flaps restored S3 to S4. The donor site of the flap was covert, and the function of the foot was unaffected.

Conclusion: The tissue structure of the modified fibular side pulp flap of great toe is similar to the dorsal skin of finger. This free flap is satisfied in the shape, easy to harvested and the blood supply was constant in its location. The appearance and function of finger were recovered well after repairing. It is avoids secondary injury of the injured finger with adopting local pedicled skin flap for repairing. It is an ideal repair method for large area dorsal skin defect of the finger.