Abstract:
Objective To observe the long-term effects of great toe widening surgery on postoperative appearance and function of the donor and recipient areas in the full-shaped reconstruction of defective fingers.
Methods From September 2020 to May 2023, a total of 12 patients (14 fingers), including 5 males (5 fingers) and 7 females (9 fingers) in Department of Hand and Foot Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University were involved. The patients were performed great toe widening surgery in the first stage, and free lateral hallux osteo-onychocutaneous flaps from the widened toe for finger reconstruction in the second stage. Before the second stage surgery, X-ray examination of the donor site′s great toe was conducted to measure the width of the widened toe nail and the width of the distal phalanx nail tuberosity. The average interval between the first stage great toe widening surgery and the second stage finger reconstruction surgery was 11.4(7-17)months. The average follow-up period after the second stage finger reconstruction was 10.8(6-26)months. The survival of the reconstructed fingers, and the appearance and function of the fingers and great toes were observed.
Results After the first stage great toe widening surgery, the average width of the toenails was increased by 1.4(0.9-1.8)cm, with an average widening ratio of 82.8%(52.9%-114.3%). The average widening of the distal phalanx nail tuberosity was 1.5(1.0-2.1)cm, with an average widening ratio of 131.9%(83.3%-190.9%). After the second stage finger reconstruction surgery, all reconstructed fingers survived completely, and did not experience vascular crisis. Long term follow-up showed that the appearance and function of the reconstructed fingers were similar to those of healthy fingers, and the width of the toenails in the donor area was close to normal. The appearance of the great toe was plump, and there were no significant abnormalities in walking and other functions.
Conclusion The great toe widening surgery used for full-shaped finger reconstruction, can ensure that the appearance and function of the reconstructed fingers are similar to those of normal fingers, without affecting the appearance and function of the great toe.
Key words:
Finger defect,
Great toe widening surgery,
Hallux osteo-onychocutaneous free flaps
Liwen Hao, Zengtao Wang, Kai Rong, Zhidian Hou, Chao Chen, Shenqiang Qiu, Linfeng Liu, Di Zhang, Yunpeng Wang, Shuo Zhong. Observation on the application effect of great toe widening surgery in full-shaped reconstruction of defective fingers[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(06): 476-479.