Transfer of composite tissue flap from the second metatarsal to repair complex tissue defects of the hand

Objective To introduce various configurations of composite tissue flap transfer from the second metatarsal for treatment of complex tissue defects of the hand.Methods From May 2003 to August 2007,9 cases of complex tissue defects of the hand were treated by the several types of composite tissue flap which included the second metatarsal bone,metatarsophalangeal joint,medial tarsal flap,lateral tarsal flap,dorsal digital flap and extensor tendons.Results All the composite flaps survived.Follow-up period ranged from 1 month to 6 months.Bone union and tendon healing were excellent.The reconstructed metacarpophalangeal joint had 0° to 60° range of motion.The contour of the repaired site was satisfactory.Conclusion Composite tissue flap transfer from the second metatarsal is a good option for repairing complex tissue defects of the hand.It provides good blood supply and can achieve one-stage repair of all the missing tissues. Key words: Hand injuries; Surgical flaps; Second metatarsal bone