title: Combined ipsilateral and contralateral second toe flaps for repair of finger degloving injury.
abstract: OBJECTIVE
  The purpose of this report was to retrospectively review the results of treatment of degloving injury of the finger by use of combined ipsilateral second dorsal nail-skin flap and contralateral medial second toe flap.
  
  
  METHODS
  From 2010 to 2012, seven fingers in seven patients with complete degloving injuries from the level of middle or distal phalanx were reconstructed with combined ipsilateral second dorsal nail-skin flap and contralateral medial second toe flap. The injured fingers included the index finger in four cases, and middle finger in three cases. The nerves of both the flaps were sutured to the bilateral common digital nerves. The donor site of second toe flap was covered with a full-thickness skin graft.
  
  
  RESULTS
  All transferred flaps survived after surgery, and all postoperative courses were uneventful. During the follow-up period (mean of 15 months; ranging 6-20 months), the appearance of the reconstructed fingers was comparable with normal ones. The range of motion of the distal interphalangeal joint averaged 55 ± 5.8 degrees. The two point discrimination of the pulp ranged from 8 to > 15 mm (average, 11.3 mm). All the patients were able to walk without difficulty. The MHQ score averaged 59 ± 4.2 points and Maryland foot rating score averaged 92 ± 4.2 points.
  
  
  CONCLUSIONS
  The ipsilateral second toe dorsal nail-skin flap combined with contralateral medial second toe flap may provide an alternative for the reconstruction of completely degloved fingers at the middle and the distal phalangeal level, with satisfactory functional and cosmetic results.
authors.affiliation: Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, 215104, China.
authors.forename: Guangliang
authors.initials: G
authors.lastname: Zhang
authors.forename: Jihui
authors.initials: J
authors.lastname: Ju
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhao
authors.forename: Xiangjun
authors.initials: X
authors.lastname: Li
authors.forename: Guangzhe
authors.initials: G
authors.lastname: Jin
authors.forename: Linfeng
authors.initials: L
authors.lastname: Tang
authors.forename: Ruixing
authors.initials: R
authors.lastname: Hou
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005384:Finger Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D014034:Toes / Q000601:surgery*; D055815:Young Adult