Arch Reconstr Microsurg.  2013 Nov;22(2):63-68.

Free Flap Coverage of the Finger Defect Caused by Digital Replantation Failure

• Shim JH
• Jeong SH

Abstract

PURPOSE
In case of the failed replantation, if the patients want to preserve the length of amputated stump, toe transfer is the ideal choice. However, reconstruction of these amputated stump with a free flap can be a useful method when the patients refuse sacrificing their toe. Our purpose of this study is to evaluate availability of functional results and patient satisfaction after this procedure.
MATERIALS AND METHODS
From March 2008 to February 2012, we reconstructed the amputated stump with free flap by patients demand. Eleven patients were included, medial plantar artery perforator flap in seven cases and great toe pulp flap in five cases. Follow-up range 12 to 24 months and we evaluate patient satisfaction by using a visual analogue scale (VAS; 1=unsatisfied, 5=excellent) and functional recovery by measuring the range of motion of remaining joint at 12 months after operation.
RESULTS
During follow-up period, all transferred free flaps survived and no major complications were noted. Range of motion of remaining joint appeared satisfactory result (15degrees to 100degrees). The VAS patient satisfaction score for aesthetic were five in six patients, four in four patients, and three in one patient.
CONCLUSION
In case of the failed digital replantation, if patient refuse toe transfer, it could be useful method to reconstruction with the free flap to preserving maximal length of amputated stump.

Keyword

Failed digital replantation; Medial plantar artery perforator flap; Great toe pulp flap

MeSH Terms

Arteries
Fingers*
Follow-Up Studies
Free Tissue Flaps*
Humans
Joints
Patient Satisfaction
Perforator Flap
Range of Motion, Articular
Replantation*
Toes