[Reverse first dorsal metatarsal artery island flap for coverage of donor defect of great toe after free lateral pulp flap transfer].
OBJECTIVE
To employ reverse first dorsal metatarsal artery island flap to recover the donor site of great toe after free lateral pulp flap transfer, and decrease the morbidity of microsurgical donor site.


METHODS
From February 2000 to June 2004, 12 cases of soft tissue defect in thumb and finger were treated by free lateral pulp flap of great toe transplantation, and that the secondary defect of great toes were repaired by reverse first dorsal metatarsal artery flap according to the anatomical communicating between first dorsal metatarsal artery and plantar metatarsal artery. The donor exposure of dorsal pedis were straightly sutured.


RESULTS
All the lateral pulp flaps of great toe and the reversed first dorsal metatarsal flaps survived uneventfully with desirable appearance and sensation. In thumb and finger defect reconstructed with lateral pulp flaps of the great toe, there was in mean static two-point discrimination of 6 mm at 10 month follow-up, that was 10 mm in reverse flaps.


CONCLUSIONS
It is an instructive and practical creation to adopt the reverse first dorsal metatarsal artery flap to recover the raw surface in the lateral aspect of the great toe, which minimizes the morbidity at the donor site and gains the twin-win results.
Kang
Qing-lin
QL
Department of Orthopedics, the 6th People's Hospital of Shanghai, Jiaotong University, Shanghai 200233, China.
Zeng
Bing-fang
BF
Chai
Yi-ming
YM
Xue
Jian-feng
JF
Jiang
Jia
J
D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000637:transplantation*; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008684:Metatarsus / Q000098:blood supply; D008875:Middle Aged; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000473:pathology*; D055815:Young Adult