J Korean Soc Plast Reconstr Surg.  2010 Jul;37(4):457-460.

Post-Traumatic Big Toe Reconstruction using Anterolateral Thigh Free Flap: A Case Report

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Gyeonggi, Korea. sceun@snubh.org

Abstract

PURPOSE
The great toe presents a reconstructive challenge for plastic surgeons. The big toe has much importance not only for the gait and the stability, but also for appearance aspects. Few reports have documented the reconstruction of big toe defects and we report a unique case of free flap reconstruction technique.
METHODS
A 41-year-old man with right great toe open fracture with soft tissue necrosis was referred from the orthopedic surgery department. On physical examination, there was the skin necrosis circumferentially and the fratured bone was severely fragmented. The metatarsophalangeal(MTP) joint of the big toe was intact. After the wound debridement, we harvested the innervated anterolateral thigh flap and transposed to the defected area. After five months, we finally retouched the flap by the dorsal defatting and distal debulking.
RESULTS
He had an uneventful postoperative course without infection, dehiscence and flap necrosis. He has remained asymptomatic for eight months without any recurrence such as the osteomyelitis. Finally, he kept the normal gait and posture with weight bearing on the reconstructed great toe and foot.
CONCLUSION
The anterolateral thigh flap is described for the reconstruction of the great toe. It involves two stage procedure with the minimal donor site morbidity and provides a good cosmetic result.

Keyword

Great toe defects; Anterolateral thigh free flap

MeSH Terms

Adult
Cosmetics
Debridement
Foot
Fractures, Open
Free Tissue Flaps
Gait
Humans
Joints
Necrosis
Orthopedics
Osteomyelitis
Physical Examination
Posture
Recurrence
Skin
Thigh
Tissue Donors
Toes
Weight-Bearing
Cosmetics
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