Artery anastomosis only in reconstruction of digit-tip defects with fibular great toe flap: a report of 8 cases
10.3760/cma.j.cn441206-20231215-00106
- VernacularTitle:只吻合动脉的 趾腓侧皮瓣修复指端创面8例
- Author:
Zengyang GAO
1
;
Chao LIU
;
Lijun SHE
;
Yanzhi CHEN
;
Qiulan DUAN
;
Jingliang ZHANG
Author Information
1. 顺德和平外科医院手外科，广东 顺德 528308
- Keywords:
Fibular great toe flap;
Digit-tip defect;
Reconstruction;
Microsurgical technique
- From:
Chinese Journal of Microsurgery
2024;47(5):539-543
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effect of free fibular great toe flap in reconstruction of digit-tip defect with only anastomosis of artery.Methods:From February 2022 to January 2023, a total of 8 patients with digit-tip defects received reconstruction surgery using free flap of fibular great toe with anastomosis of artery only in the Department of Hand Surgery, Shunde Heping Surgical Hospital. The patients were 5 males and 3 females, with an average age of 33 (14-55) years old. Two defected digit-tips were of thumbs, 3 of index fingers, 2 of middle fingers and 1 of little finger. The digit-tip defects were 1.5 cm×0.5 cm-2.0 cm×1.2 cm in size. During the surgery, a perforator flap of fibular great toe with fibular plantar digital artery and a branch of digital nerve was harvested. And the artery and nerve carried by the flap were anastomosed to the digital artery arch and nerve of the recipient site. No reflux vein was included in the free flap due to the small size of flap. The donor sites were directly closed. Postoperative anti-infection, anti-coagulation, and anti-vasospasm were offered. Scheduled postoperative follow-ups were conducted at outpatient clinics after surgery.Results:All flaps survived smoothly without any vascular compromise. All patients were included in the follow-up with an average of 7.1 (5-13) months. At the final follow-up, the appearances of the digit-tips were full and beautiful, with recovered finger print and good stability of flaps, as well as normal sweating. All flaps had good sensation recovery, with TPD at 6.0 mm to 7.5 mm and at 6.7 mm in average. There was no significant difference in skin temperature between the donor sites and the healthy sides. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 7 patients were rated as excellent and 1 as good.Conclusion:The clinical effect is excellent for the free flap of fibular great toe with anastomosis of artery only in the reconstruction of digit-tip defect. It not only has satisfactory reconstruction but also restores the appearance and function of the flap donor site. Worth promoting and applying in clinical practice.
