ABSTRACT
Objective:
To explore the
method and effect of aesthetic reconstruction of distal segment of
finger with modified second
toe nail flap while retains the full length of the second
toe.
Methods:
From April 2018 to June 2020, 16
patients with
degloving injury of distal segment of
fingers were treated. The
patients were 11
males and 5
females aged 18 to 45 years in an average of 29 years. All
injuries were
degloving injury of the distal segment of
finger, including 5 index
fingers, 7 middle
fingers, 3 ring
fingers and 1 little
finger. The
time from
injury to operation was 0.5-3.0 hours, with an average of 1.5 hours. The second
toe nail flap was used for the reconstruction. After the dorsal flap of the second
toe was rotated to the plantar side of the
foot, the
donor site defect was repaired by a
skin graft. The regular follow up reviews were carried out.
Results:
All 16 flaps survived except 1 flap had
necrosis and underwent
toe amputation of the distal segment of the second
toe. All
patients entered follow-up for 4-12 months, with an average of 5.7 months. The
blood supply of all flaps was good. After the flaps having atrophied, they were equivalent to the diameter of the body of normal
fingers with the TPD at 6.5(4-10) mm; All
patients returned to
work. According to the Evaluation Standard of
Upper Limb Function of
Chinese Hand Surgery Society, 13 cases were graded as excellent, 2 were good and 1 was fair.
Conclusion:
The
techniques of modified second
toe toenail flap in aesthetic reconstruction of the distal segment of a
finger can effectively restore the length and aesthetic appearance of the affected
finger, without sacrificing the
donor toe. Clinical application of it should be promoted.