Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers

• Main Authors: Yong Jin Cho, Si Young Roh, Jin Soo Kim, Dong Chul Lee, Jae Won Yang
• Format: Article
• Language: English
• Published: Korean Society of Plastic and Reconstructive Surgeons 2013-05-01
• Series: Archives of Plastic Surgery
• Subjects: Free tissue flaps; Softtissue injuries; Fingerinjuries
• Online Access: http://e-aps.org/Synapse/Data/PDFData/2023APS/aps-40-226.pdf

Background  The reconstruction of volar surface defects is difficult because of the specialhistologic nature ofthe tissue involved. The plantarsurface isthe most homologousin shapeand function and could be considered the mostideal ofreconstructive optionsin select casesof volar surface defects. In this paper, we evaluate a single institutional case series of volartissue defectsmanagedwith second toe plantarfree flaps.Methods  Asingle-institution retrospective reviewwas performed on 12 cases ofreconstructionusing a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years) witha 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 (6cases)were forsoft-tissue defectswith the other halfforscar contracture.Results  All ofthe flapssurvived through the follow-up period. Sensory recoverywasrelatedto the time interval between injury and reconstruction−with delayed operations portendingworse outcomes. Therewere no postoperative complicationsin thisseries.Conclusions  Flexion contracture is the key functional deficit of volar tissue defects. Thesecond toe plantar free flap is the singular flap whose histology most closely matches thoseof the original volar tissue. In our experience, this flap is the superior reconstructive optionwithin the specific indications dictated by the defectsize and location.