Segmental second toe transfer for reconstruction of composite tissue defect of the digit

Objective To explore the surgical method and clinical effect of repairing composite tissue defects of the digit by transplanting a segment of the second toe.Methods Between June 2007 and August 2011,8 cases of composite tissue defect of the digits including 3 cases of thumb defect,2 cases of index finger defect,2 cases of middle finger defect and 1 case of ring finger defect were treated in our hospital by transplanting a segmem of the second toe.Transfer of a segment of the second toe containing the proximal interphalangeal joint was done in 4 cases,while the other 4 cases received a second toe segment without the interphalangeal joint.The donor sites were closed by amputating the remaining of the second toe in all the cases.Results Vasospasm occurred in one case during the operation and was relieved by local application of papaverine.All the transplants and reconstructed fingers and thumbs survived.The wounds at both recipient and donor sites healed primarily.The patients were follow-up for 6 to 24 months (mean,12 months).All repaired digits presented satisfactory appearance and recovered the function of flexion,extension,grip and pinch.The donor sites only had linear scars and no functional impairment was observed.According to the assessment criteria of replantation of anputated finger formulated by the Chinese Medical Association,the results were excellent in 2 cases,good in 5cases and moderate in 1 case with the excellent and good rate of 87.5 ％.Conclusion Although utilizing a segment of the second toe to repair composite tissue defects of the digits has some degree of difficulty and risk,the recorstructed fingers have good appearance and function.This surgical method deserves general application. Key words: Finger injuries;  Microsurgery;  Tissue transplantation