Reconstruction of distally degloved fingers with a cross-finger flap and a composite-free flap from the dorsum of the second toe.

Purpose In this article, we report the reconstruction of degloved fingers using a combination of a cross-finger flap and a composite-free flap from the dorsal aspect of the second toe. Methods From May 2006 until April 2009, we treated 18 degloved fingers in 18 patients (13 male and 5 female patients; mean age, 22 y) using the technique. There were 11 index and 7 ring fingers. The mean volar and dorsal defects were 2.5 X 1.9 cm and 2.7 x 2 cm, respectively. The cross-finger flaps ranged in size from 2.3 X 1.6 cm to 3.5 X 2.6 cm, with a mean of 2.8 x 2.3 cm. The flaps from the dorsal second toe ranged in size from 2.4 X 2.1 cm to 4.5 X 2.3 cm, with a mean of 3.0 X 2.2 cm. At follow-up, we assessed motion and sensation. Results All cross-finger and free flaps survived. At final follow-up (mean, 17 mo; range, 14-25 mo), motion in the injured fingers averaged 102 degrees and 28 degrees at the proximal and distal interphalangeal joints, respectively. The mean static 2-point discrimination of the reconstructed finger pulps was 5 mm (range, 4-7 mm). Conclusions The combination of a cross-finger flap and a composite-free flap from the dorsum of the second toe is a useful and reliable technique for reconstruction of a degloved finger. (J Hand Surg 2012;37A:303-309. Copyright (C) 2012 by the American Society for Surgery of the Hand. All rights reserved.)