OBJECTIVETo investigate the clinical effect of reversed plantar metatarsal artery island flap in repairing the plantar soft tissue defects at the first and second toes.

METHODS12 cases with plantar soft tissue defects at the first and second toes were repaired by reversed plantar metatarsal artery island flap which size ranged from 2 cm x 3 cm to 4 cm x 6 cm, including 5 cases at emergency, 5 cases with the donor site defects at great toes after free lateral pulp flap transfer, and 2 cases with the donor site defects at second toes after free medial pulp flap transfer.

RESULTSAll the reversed plantar metatarsal artery island flaps at the first and second toes survived uneventfully with desirable appearance and sensation over a 3-35 month follow-up. No complication happened at the donor sites.

CONCLUSIONSIt is an reliable method to adopt the reversed plantar metatarsal artery island flap for the plantar soft tissue defects at the first and second toes, with the advantages of stable blood vessels, high survival rate, good skin texture and few complications.

Arteries ; Foot ; Humans ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; transplantation ; Toes ; Transplant Donor Site ; blood supply

BACKGROUNDFingertip defect significantly affects the appearance of the hand. The aim of this research was to evaluate the clinical effect of aesthetic fingertip reconstruction with partial second toe transfer.

METHODSBetween July 2005 and December 2008, 17 patients underwent aesthetic fingertip reconstruction with partial second toe transfer. The mean size of fingertip defects was 0.7 cm (ranging from 0.5 - 1.1 cm). Anastomosis was performed between one dominant plantar digital artery and one proper digital artery, between two dorsal digital veins of the toe and two dorsal digital veins of the finger, respectively, for the reconstruction of blood supply to the reconstructed finger. Two plantar digital nerves of the toe were then sutured to two proper digital nerves of the finger for the restoration of fingertip sensation.

RESULTSAll reconstructed fingers survived completely. The follow-up period ranged from 6 to 24 months, and the appearance of the reconstructed fingertip was similar to that of the normal fingertip. Two-point discrimination of the reconstructed fingertip was (7.8 ± 1.3) mm. The recovered pinch strength of the reconstructed finger was about (89.0 ± 5.1)% of that of the normal finger. Donor site healed well without complications.

CONCLUSIONSPartial second toe transfer is an ideal aesthetic reconstruction method for fingertip defects; it can not only achieve a satisfactory appearance of the fingertip, but can also obtain excellent sensory and motor functions.

Adolescent ; Adult ; Antisepsis ; Female ; Fingers ; blood supply ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Toes ; transplantation

OBJECTIVETo investigate an ideal method for finger reconstruction with extended the second toe flap transfer.

METHODSThe second toe free flap was created, combined with an pedicled skin flap from the fibular side of the great toe inlaid in the ventral side of the second toe, a double-wing flap and the distal part of the metatarsal bone. The composite free flap was transferred by vascular anastomosis for finger reconstruction.

RESULTSThe reconstructed finger exhibited nice looking and better function. The procedure had little influence to the appearance and function of the donor foot.

CONCLUSIONThis method is effective in ameliorating the appearance and function of the reconstructed finger with the second toe transfer.

Adult ; Female ; Fingers ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply ; Toes ; surgery ; Treatment Outcome

Hepatorenal syndrome is a severe complication of cirrhosis, leading to death in more than 90% of cases in the absence of liver transplantation. Several treatments have been attempted as a bridge to liver transplantation. Among such treatments, terlipressin is a nonselective V1 vasopressin agonist. When comparing with ornipressin, it is known to have a similar vasoconstricting potency, but much less ischemic complication. We report a case of gangrene on toes and necrosis on the infusion site of left hand which developed after the use of terlipressin due to hepatorenal syndrome in a 41-year-old-man with liver cirrhosis. Ischemic complication of terlipressin is rare and there has been no case report in Korea. Although it is rare, we must pay attention to the peripheral ischemic complication of terlipressin.
Adult ; Hand/*blood supply ; Hepatorenal Syndrome/drug therapy ; Humans ; Ischemia/*chemically induced ; Lysine Vasopressin/adverse effects/*analogs & derivatives/therapeutic use ; Male ; Toes/*blood supply ; Vasoconstrictor Agents/*adverse effects/therapeutic use

OBJECTIVETo report the application of reverse second dorsal metatarsal artery island flap for From May 2005 to September 2008, 5 cases with soft tissue repairing the soft tissue defect at toes.

METHODSdefects at toes were treated with reverse second dorsal metatarsal artery island flaps. The flaps size ranged from 2 cm x 3 cm to 5 cm x 6 cm.

RESULTSAll the 5 flaps survived completely. The patients could walk 1-2 months after operation. The patients were followed up for 5-7 months with good appearance, texture and sensation of toes.

CONCLUSIONThe reverse second dorsal metatarsal artery island flap has a reliable blood supply and good tissue texture. It is a practical method for repairing the soft tissue defect at toes.

Adult ; Fascia ; transplantation ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Toes ; injuries ; Young Adult