Arch Hand Microsurg 2019; 24(1): 79-86  
Volar Open V-Y Flap for Distal Toe Injury
Yo Han Lee, Young Ho Lee, Min Bom Kim, Che Ho Lee, Goo Hyun Baek
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
Correspondence to: Young Ho Lee
Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
TEL: +82-2-2072-0894, FAX: +82-2-764-2718, E-mail: orthoyhl@snu.ac.kr
Received: October 16, 2018; Revised: December 11, 2018; Accepted: December 24, 2018; Published online: March 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Soft tissue construction of the toe is challenging because there are low blood supply and lack of available soft tissue around the defect. The purpose of this study is to evaluate the therapeutic effect of an open V-Y flap in toe-tip amputations.
Methods: Among the cases that involved treatment with Open V-Y flap for the reconstruction of soft tissue defects of great toe between January 2012 to December 2015, only those cases encountered more than six months ago were evaluated. A total of five patients were enrolled between the ages of 24 and 54. The results were assessed by a flap survival, residual pain and complications such as hook nail deformity at last day of follow-up.
Results: In all of five cases, flaps were entirely survived without complications. All patients can walk without disability after three weeks from surgery. More than 80% of sensory recovery was reported subjectively compared to the intact side six months after the surgery without residual pain. No partial flap necrosis, recurrence of skin defects or ulcers were observed. The 4 cases survived without hook nail deformity except for 1 case that was a complete loss of nail at the initial injury.
Conclusion: The volar open V-Y flap in toe-tip amputation has a simple procedure, low complications, minimal donor site morbidity, and excellent sensory recovery. Therefore, it is considered one of the proper treatments for toe-tip amputations.
Keywords: Foot injuries, Toes, Surgical flap, Malformed nails


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