Reconstruction of distal thumb avulsion injury by a tiled flap combined with a hallux nail flap and a lateral flap of the second toe: a case report

VernacularTitle:甲瓣联合第2足趾侧方皮瓣瓦合修复拇指末节脱套伤1例
Author: Shuai DONG ¹ ; Jihui JU ; Kai WANG ; Shi WANG ; Chengwei GE ; Linfeng TANG ; Ruixing HOU
Author Information

1. 苏州瑞华骨科医院手外科，苏州　215104
Publication Type:Journal Article
Keywords: Hallux nail flap; Lateral flap of toe; Degloving injury; Thumb; Tiled flap; Reconstruction
From: Chinese Journal of Microsurgery 2025;48(5):577-579
CountryChina
Language:Chinese
Abstract: In January 2021, a young male patient was admitted to the Department of Hand Surgery, Suzhou Ruihua Orthopeadic Hospital for a soft tissue degloving defect of distal segment of right thumb caused by machine compression. The thumb defect was reconstructed using a tiled flap with a right hallux nail flap and a lateral flap of left second toe. Donor site of the hallux nail flap was reconstructed by a lateral flap of right second toe, while the donor site of lateral flap of left second toe was covered by a skin graft of abdomen. At 1-year follow-up, the reconstructed nail was found excellent according to the established criteria. Two-point discrimination (TPD) was measured at 5 mm, and the affected thumb exhibited satisfactory flexion and extension and functions of thumb-to-palm and thumb-to-fingers oppositions. Donor sites in both feet achieved favorable appearance and function, with a Maryland foot score of 96. Only a linear scar was in abdominal donor site.