To investigate the clinical effect of dorsal metatarsal relay flap in repairing the donor site of the second toe free flap.

From June 2020 to October 2025， 7 patients who met the inclusion criteria and underwent second toe free flap reconstruction for hand wounds were admitted to the Department of Hand Surgery of Suzhou Ruihua Orthopedic Hospital. There were 5 males and 2 females， aged 22 to 56 years， with an average age of 32.6 years. The donor sites of the second toe free flaps in all patients were repaired using dorsal metatarsal relay flaps， the area of the relay flaps ranged from 2.0 cm×1.5 cm~3.0 cm×2.5 cm， and the donor sites of the relay flaps were sutured directly. Postoperative follow-up was performed to evaluate the dorsal metatarsal relay flap in terms of appearance， color， texture， two-point discrimination， and scar hyperplasia.

The dorsal metatarsal relay flaps and second toe free flaps of 7 patients survived after surgery. Postoperative follow-up ranged from 2-14 months， with an average of 7 months. The appearance of the dorsal metatarsal relay flaps were satisfactory， with color close to the contralateral side and soft texture. The two-point discrimination distance was 7-12 mm， with an average of 8.5 mm. The walking function of the foot was good， and there was no contracture between the toe webs.

Repairing the donor site of the second toe free flap using dorsal metatarsal relay flap offers the advantages of simple surgical technique， fewer complications， and high flap survival rate， making it suitable for clinical application.