title: Modified Great Toe Wraparound Flap with Preservation of Plantar Triangular Flap for Reconstruction of Degloving Injuries of the Thumb and Fingers: Long-Term Follow-Up.
abstract: BACKGROUND
  The purpose of this article is to report the authors' experience with the use of the modified great toe wraparound flap with preservation of a plantar triangular flap for reconstructing degloving injuries of the thumb and fingers.
  
  
  METHODS
  Between 2007 and 2012, 31 patients underwent reconstruction with 37 flaps. Twenty-seven patients underwent reconstruction with 31 flaps for a degloved thumb and fingers, and four patients underwent reconstruction with six flaps for degloved fingers only. A modified great toe wraparound flap with second toe medial toe hemipulp flap on a common pedicle was used for reconstruction of degloved fingers in four patients. Twelve patients had long-term follow-up, with a mean duration of 5 years (range, 2 to 8 years).
  
  
  RESULTS
  All flaps survived. The contour of the reconstructed digits was similar to the contralateral one. In patients with long-term follow-up, mean two-point discrimination of reconstructed digits was 6.2 mm (range, 3 to 8 mm). Mean Disabilities of the Arm, Shoulder and Hand questionnaire score was 0.8 ± 1.0. Mean Michigan Hand Outcomes Questionnaire score was 87.3 ± 3.7. Mean Foot and Ankle Disability Index score was 95.5 ± 2.7. The width of the preserved plantar triangular flap expanded from 35 percent to 67 percent of the width of the great toe and completely covered the weight-bearing area.
  
  
  CONCLUSIONS
  Reconstruction of degloved thumb and fingers with a modified great toe wraparound flap, preserving a plantar triangular flap, results in excellent contour and functional outcome. Donor-site morbidity in the foot was minimal.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Wuxi, People's Republic of China; and Miami, Fla.|From the Department of Hand Surgery, Wuxi Ninth People's Hospital; and the Division of Plastic Surgery, University of Miami.
authors.forename: Xiao Fang
authors.initials: XF
authors.lastname: Shen
authors.affiliation: Wuxi, People's Republic of China; and Miami, Fla.|From the Department of Hand Surgery, Wuxi Ninth People's Hospital; and the Division of Plastic Surgery, University of Miami.
authors.forename: Jing Yi
authors.initials: JY
authors.lastname: Mi
authors.affiliation: Wuxi, People's Republic of China; and Miami, Fla.|From the Department of Hand Surgery, Wuxi Ninth People's Hospital; and the Division of Plastic Surgery, University of Miami.
authors.forename: Ming Yu
authors.initials: MY
authors.lastname: Xue
authors.affiliation: Wuxi, People's Republic of China; and Miami, Fla.|From the Department of Hand Surgery, Wuxi Ninth People's Hospital; and the Division of Plastic Surgery, University of Miami.
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
authors.affiliation: Wuxi, People's Republic of China; and Miami, Fla.|From the Department of Hand Surgery, Wuxi Ninth People's Hospital; and the Division of Plastic Surgery, University of Miami.
authors.forename: Li
authors.initials: L
authors.lastname: Qiang
authors.affiliation: Wuxi, People's Republic of China; and Miami, Fla.|From the Department of Hand Surgery, Wuxi Ninth People's Hospital; and the Division of Plastic Surgery, University of Miami.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Wuxi, People's Republic of China; and Miami, Fla.|From the Department of Hand Surgery, Wuxi Ninth People's Hospital; and the Division of Plastic Surgery, University of Miami.
authors.forename: Yong Jun
authors.initials: YJ
authors.lastname: Rui
authors.affiliation: Wuxi, People's Republic of China; and Miami, Fla.|From the Department of Hand Surgery, Wuxi Ninth People's Hospital; and the Division of Plastic Surgery, University of Miami.
authors.forename: Harvey
authors.initials: H
authors.lastname: Chim
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D002648:Child; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries / Q000601:surgery*; D013997:Time Factors; D014034:Toes / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult