Arch Hand Microsurg.  2019 Mar;24(1):79-86. 10.12790/ahm.2019.24.1.79.

Volar Open V-Y Flap for Distal Toe Injury

Affiliations
  • 1Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea. orthoyhl@snu.ac.kr

Abstract

PURPOSE
Soft tissue construction of the toe is challenging because there are low blood supply and lack of available soft tissue around the defect. The purpose of this study is to evaluate the therapeutic effect of an open V-Y flap in toe-tip amputations.
METHODS
Among the cases that involved treatment with Open V-Y flap for the reconstruction of soft tissue defects of great toe between January 2012 to December 2015, only those cases encountered more than six months ago were evaluated. A total of five patients were enrolled between the ages of 24 and 54. The results were assessed by a flap survival, residual pain and complications such as hook nail deformity at last day of follow-up.
RESULTS
In all of five cases, flaps were entirely survived without complications. All patients can walk without disability after three weeks from surgery. More than 80% of sensory recovery was reported subjectively compared to the intact side six months after the surgery without residual pain. No partial flap necrosis, recurrence of skin defects or ulcers were observed. The 4 cases survived without hook nail deformity except for 1 case that was a complete loss of nail at the initial injury.
CONCLUSION
The volar open V-Y flap in toe-tip amputation has a simple procedure, low complications, minimal donor site morbidity, and excellent sensory recovery. Therefore, it is considered one of the proper treatments for toe-tip amputations.

Keyword

Foot injuries; Toes; Surgical flap; Malformed nails

MeSH Terms

Amputation
Congenital Abnormalities
Follow-Up Studies
Foot Injuries
Humans
Nails, Malformed
Necrosis
Recurrence
Skin
Surgical Flaps
Tissue Donors
Toes*
Ulcer
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