Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.5999/aps.2013.40.3.226
Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers
![](https://www.thieme-connect.de/media/10.1055-s-00051611/201303/lookinside/thumbnails/10_5999_aps_2013_40_3_226_226-1.jpg)
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.
This article was presented at the 69th Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 11-13, 2011 in Seoul, Korea.
Publication History
Received: 01 December 2012
Accepted: 01 February 2013
Article published online:
01 May 2022
© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Cho SB, Choi JK, Lee DC. et al. Reconstruction of the skin defects of the hand using versatile venous free flaps. J Korean Soc Plast Reconstr Surg 1995; 22: 875-883
- 2 Okazaki M, Hasegawa H, Kano M. et al. A different method of fingertip reconstruction with the thenar flap. Plast Reconstr Surg 2005; 115: 885-888
- 3 Cohen BE, Cronin ED. An innervated cross-finger flap for fingertip reconstruction. Plast Reconstr Surg 1983; 72: 688-697
- 4 Yang JW, Kim JS, Lee DC. et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. J Reconstr Microsurg 2010; 26: 529-538
- 5 Lee GJ, Kim KC, Yu SO. et al. Reconstruction of soft tissue defects of multiple digits with arterialized venous free flap. J Korean Soc Surg Hand 2004; 9: 12-20
- 6 De Lorenzi F, van der Hulst RR, den Dunnen WF. et al. Arterialized venous free flaps for soft-tissue reconstruction of digits: a 40-case series. J Reconstr Microsurg 2002; 18: 569-574
- 7 Lee DC, Kim JS, Ki SH. et al. Partial second toe pulp free flap for fingertip reconstruction. Plast Reconstr Surg 2008; 121: 899-907
- 8 Kamei K, Ide Y, Kimura T. A new free thenar flap. Plast Reconstr Surg 1993; 92: 1380-1384
- 9 Kimata Y, Mukouda M, Mizuo H. et al. Second toe plantar flap for partial finger reconstruction. Plast Reconstr Surg 1998; 101: 101-106
- 10 Kimura N. Versatility of a second toe plantar flap. J Reconstr Microsurg 2009; 25: 47-53