title: Post-traumatic big toe reconstruction using free flaps.
abstract: The big toe is of great importance for good stability and gait, but few reports have documented reconstruction of big toe defects. In this study, seven male patients, aged 17 to 59 years at surgery (average: 35 years), were treated for big toe defects. The metatarsophalangeal (MTP) joints of the big toe were intact in all patients. Five patients were treated with free peroneal flaps (including one perforator flap), and two with free scapular flaps; flap sizes ranged from 9 x 4 to 24 x 6 cm. Follow-up periods ranged from 10 to 29 months, (average: 16.6 months). The iliac was used as the grafted bone in four patients and the scapula in one. Six flaps survived completely, and bone unions were achieved within 3 months. One flap became partially necrotic due to arterial thrombosis. All patients returned to their original jobs, and the cosmetic appearances of all toes were acceptable.
authors.affiliation: Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yajima
authors.forename: Keiichi
authors.initials: K
authors.lastname: Murata
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kobata
authors.forename: Koji
authors.initials: K
authors.lastname: Shigematsu
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawamura
authors.forename: Osamu
authors.initials: O
authors.lastname: Kisanuki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Takakura
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000601:surgery; D006085:Graft Survival; D006214:Hallux / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000473:pathology; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D013927:Thrombosis / Q000209:etiology; D014945:Wound Healing / Q000502:physiology