title: Second toe plantar free flap for volar tissue defects of the fingers.
abstract: BACKGROUND
  The reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps.
  
  
  METHODS
  A single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years) with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases) followed by amputations (3 cases) and a single case of burn injury. Half of the indications (6 cases) were for soft-tissue defects with the other half for scar contracture.
  
  
  RESULTS
  All of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series.
  
  
  CONCLUSIONS
  Flexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kwang-Myung Sung-Ae General Hospital, Gwangmyeong, Korea.
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Cho
authors.forename: Si Young
authors.initials: SY
authors.lastname: Roh
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Dong Chul
authors.initials: DC
authors.lastname: Lee
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Yang
keywords: Finger injuries; Free tissue flaps; Soft tissue injuries