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

Objectives: To 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.
Methods: We 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).
Results: All 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).
Conclusions: Second 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.
(Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)