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

Gu, Jiaxiang; Regmi, Subhash; Zhang, Naichen; Liu, Hongjun; Zhang, Wenzhong; Xu, Tao

doi:10.1016/j.bjps.2015.10.017

Cited by 4 publications

(8 citation statements)

References 16 publications

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“…The small finger showed a borderline loss of protective touch (Bell‐Krotoski, ). Several studies have reported diminished sensation to light touch and protective touch to be the most common outcome overall (Gu et al, ; Kotkansalo, Vilkki, & Elo, ; Venkatramani, Bhardwaj, Sierakowski, & Sabapathy, ).…”

Section: Discussionmentioning

confidence: 99%

“…This concept is well known but rarely reported in the literature with such lengthy follow‐up and detailed outcomes measures. Previous reports failed to include comprehensive outcome measures such as PROMIS subscales and EuroQol (Garagnani et al, ; Gu et al, ; Hierner & Berger, ; Kotkansalo et al, ; Kvernmo & Tsai, ; Lee et al, ; Tonkin et al, ; Tsubokawa et al, ; Venkatramani et al, ; Wallace & Wei, ; Zhao et al, ). Others utilized different outcome measures such as the Tamai (Kotkansalo et al, ; Venkatramani et al, ) scoring system, Sollerman (Kotkansalo et al, ) hand function test, Cold Intolerance Severity Score (Gu et al, ), or the Oxford Ankle Foot Questionnaire (Garagnani et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports failed to include comprehensive outcome measures such as PROMIS subscales and EuroQol (Garagnani et al, ; Gu et al, ; Hierner & Berger, ; Kotkansalo et al, ; Kvernmo & Tsai, ; Lee et al, ; Tonkin et al, ; Tsubokawa et al, ; Venkatramani et al, ; Wallace & Wei, ; Zhao et al, ). Others utilized different outcome measures such as the Tamai (Kotkansalo et al, ; Venkatramani et al, ) scoring system, Sollerman (Kotkansalo et al, ) hand function test, Cold Intolerance Severity Score (Gu et al, ), or the Oxford Ankle Foot Questionnaire (Garagnani et al, ). Many failed to include foot outcomes altogether (Gu et al, ; Hierner & Berger, ; Kotkansalo et al, ; Kvernmo & Tsai, ; Lee et al, ; Tonkin et al, ; Tsubokawa et al, ; Venkatramani et al, ; Wallace & Wei, ; Zhao et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Others utilized different outcome measures such as the Tamai (Kotkansalo et al, ; Venkatramani et al, ) scoring system, Sollerman (Kotkansalo et al, ) hand function test, Cold Intolerance Severity Score (Gu et al, ), or the Oxford Ankle Foot Questionnaire (Garagnani et al, ). Many failed to include foot outcomes altogether (Gu et al, ; Hierner & Berger, ; Kotkansalo et al, ; Kvernmo & Tsai, ; Lee et al, ; Tonkin et al, ; Tsubokawa et al, ; Venkatramani et al, ; Wallace & Wei, ; Zhao et al, ). Some used visual analog scale scores to assess patient satisfaction with flap or toe appearance (Gu et al, ; Kotkansalo et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, prior studies after hallux valgus surgery and other toe-related procedures cite average FFI-R scores of 36-50, showing that the patient's overall foot health in regards to pain, difficulty walking, and activity limitation was satisfactory (Dux, Smith, & Rottier, 2013;Hunt et al, 2014). EuroQol (Garagnani et al, 2012;Gu et al, 2016;Hierner & Berger, 2008;Kotkansalo et al, 2009;Kvernmo & Tsai, 2011;Lee et al, 2008 Venkatramani et al, 2016) scoring system, Sollerman (Kotkansalo et al, 2009) hand function test, Cold Intolerance Severity Score (Gu et al, 2016), or the Oxford Ankle Foot Questionnaire (Garagnani et al, 2012). Many failed to include foot outcomes altogether (Gu et al, 2016;Hierner & Berger, 2008;Kotkansalo et al, 2009;Kvernmo & Tsai, 2011;Lee et al, 2008;Tonkin et al, 2005;Tsubokawa et al, 2003;Venkatramani et al, 2016;Wallace & Wei, 2007;Zhao et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of digit planer injuries using component transfer of double second toes: A case report

et al. 2019

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The purpose of this report is to show that customized component second‐toe transfers may improve functional and aesthetic outcomes following bone, soft tissue, and joint destruction of traumatically injured digits. A 22‐year‐old male sustained a planer injury resulting in loss of the distal volar soft tissues of the middle, ring, and small fingers, along with variable destruction of middle phalanges and distal interphalangeal joints. Simultaneous vascularized second‐toe transfers were performed with customized joint and pulp reconstruction of middle and small fingers. The ring finger was salvaged using non‐vascularized autologous bone graft and acellular dermal matrix. The patient had an uncomplicated postoperative course. Five‐year strength, sensory and patient reported outcomes represent overall satisfactory results. Strength testing revealed the injured hand to perform within 90% strength of the uninjured side. Sensory outcomes showed present but diminished sensory perception in each of the injured digits. The patient's upper extremity function, physical health, quality of life, and foot health were overall acceptable, and he returned to using his hand for typing, writing, weight‐lifting, and woodworking.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Reconstruction of digit planer injuries using component transfer of double second toes: A case report

et al. 2019

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The modified second toe flap technique based on the dorsal digital artery of the toe in finger pulp reconstruction

Jin

Zhang

et al. 2023

Microsurgery

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BackgroundThe second toe flap is a widely used innervated neurovascular flap for repairing finger pulp defects. It mainly carries the proper plantar digital artery and nerve. But the donor site morbidity and arterial injury are common. The report retrospectively evaluated the clinical outcomes of the second toe free medial flap based on dorsal digital artery of the toe to investigate the esthetics and function in the treatment of soft tissue defects of fingertip pulp.MethodsFrom March 2019 to December 2020, 12 patients with finger pulp defects (seven acute crush, three cut, and two burn) undergoing the modified second toe flap were chosen for retrospective review. The average patient age was 38.6 (range: 23–52) years. The mean defect size was 2.1 × 1.6 (range: 1.5 × 1.3–2.6 × 1.9) cm. The defects did not extend beyond the distal interphalangeal joint and the phalanges were not damaged in all cases. The average follow‐up was 9.5 (range: 6–16) months. Demographic information, flap data, and perioperative characteristics were collected.ResultsThe mean size of the modified flap was 2.3 × 1.8 (range: 1.7 × 1.5–2.7 × 2.0) cm and mean diameter of artery was 0.61 (range: 0.45–0.85) mm. The mean flap harvested time and operation time were 22.6 (range: 16–27) minutes and 133.7 (range: 101–164) minutes. A flap was ischemic after first day postoperatively and later it improved by releasing the sutures. All flaps were survival without necrosis. One patient was not satisfied with the appearance of the finger pulp because of scar hyperplasia. The other 11 patients were satisfied with the appearance and function of the injured digit after 6 months postoperatively.ConclusionThe modified second toe flap technique based on the dorsal digital artery of the toe is a feasible choice to reconstruct the sensation and appearance of the injured fingertip with current microsurgical techniques.

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Modified Heterodigital Neurovascular Island Flap for Sensory Reconstruction of Pulp or Volar Soft Tissue Defect of Digits

Wang

Yang

Chen

et al. 2020

The Journal of Hand Surgery

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

Cited by 4 publications

References 16 publications

Reconstruction of digit planer injuries using component transfer of double second toes: A case report

Reconstruction of digit planer injuries using component transfer of double second toes: A case report

The modified second toe flap technique based on the dorsal digital artery of the toe in finger pulp reconstruction

Modified Heterodigital Neurovascular Island Flap for Sensory Reconstruction of Pulp or Volar Soft Tissue Defect of Digits

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