ePlasty: Vol. 18
Salvage of Thumb With a Free Skin Flap From the Great Toe
Xingchen Li, BA, Stephen Viviano, MD, and Ramazi Datiashvili, MD, PhD

Division of Plastic Surgery, Department of Surgery, Rutgers University/New Jersey Medical School, Newark


Correspondence: xl276@njms.rutgers.edu
Keywords: thumb reconstruction, hand surgery, microsurgery, free tissue transfer, salvage

DESCRIPTION

The patient was a 52-year-old man who suffered an avulsion amputation injury to his left thumb. Examination revealed a left thumb distal tip amputation and a 7×3-cm open wound over the entire pulp and half of the proximal phalanx (Fig 1).

Figure 1. (a) Left thumb distal tip avulsion amputation with an extended full-thickness volar skin loss. (b) Intraoperative markings showing the lazy S-incision over the dorsalis pedis artery and the templated area of harvest. (c) Intraoperative view of the raised lateral toe flap with intact pedicle. (d) View of the left thumb 5 weeks after reconstruction.

QUESTIONS

1. What factors must be considered when approaching reconstruction of a volar thumb injury?

2. What local flap options exist for volar thumb reconstruction and what are the limit .......