Abstract:

BACKGROUND: The second toe and toe-nail flap with dorsal petal artery as blood supply for finger reconstruction have been widely practiced in clinic. However, there is a difficulty in the process of operation since anatomic variation of dorsal petal artery happens to some patients. The second set of blood supply system- the first dorsal metatarsal artery and the second dorsal petal artery- provides a solution to the problem.
OBJECTIVE: To explore the clinical significance of free second toe or toe-nail flap transplantation for finger reconstruction and dorsal petal artery variation.
METHODS: The free second toe or toe-nail flap transplantation for thumb reconstructon were performed in 15 cases, and the second blood supply system was adopted -the first dorsal metatarsal artery and the second dorsal petal artery. According to the probational standard (2005-3-25) issued by the Chinese Medical Association for surgery of the hand, patients evaluated reconstructed thumb function themselves considering the length, shape, function, and feeling recovery of the thumb.
RESULTS AND CONCLUSION: The reconstructed thumbs all survived without complications. All patients were followed up for 5 months to 2 years, and the excellent rate was 93% as the function was well recovered, length was suitable, and recovering feeling was good. Reexamination of the donor foot showed that its outline was still good and patients could reposefully walk without pain. The key to the success of thumb reconstruction is a good job for preoperative preparation, intra-operative non-invasive operation followed by careful observation, familiar with the foot anatomy, especially the dorsal petal artery variation and the anatomy in the second set of blood supply system.