The First Web Space Free Flap of the Foot to Reconstruct the Pulp of Fingers

Kong,  Byeong Seon; Kim,  Yun Seok; Lee,  Hyeong Seok; Jung,  Dae Won; Kwak,  Jae Yong; Lee,  Hyun Suk

doi:2012.21.2.153

Arch Hand Microsurg > Volume 21(2); 2012 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2012;21(2):153-158.
Published online November 30, 2012.
DOI: https://doi.org/10.12790/jkssh.2012.21.2.153

The First Web Space Free Flap of the Foot to Reconstruct the Pulp of Fingers

Byeong Seon Kong, M.D.*, Yun Seok Kim, M.D.*, Hyeong Seok Lee, M.D., Dae Won Jung, M.D., Jae Yong Kwak, M.D. and Hyun Suk Lee, M.D.

¹Department of Orthopedic Surgery, Micro Orthopedic Clinic, Busan, Korea.
²Department of Orthopedic Surgery, Maryknoll Hospital, Busan, Korea. dr.leehyeongseok@gmail.com

수지 수질부 재건을 위한 족부의 제 1물갈퀴부 유리 피판술

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Abstract

Purpose: The first web space of the foot has a similar thickness and skin texture of the pulp of the fingers. Moreover, it has a reliable blood vessel and sensory nerve. The purpose of this study was to evaluate the clinical results of the first web space free flap to reconstruct the pulp of fingers.
Materials and Methods: Authors have performed 23 cases of first web space free flap to reconstruct the pulp defect of the fingers between June 2004 and May 2009. The age of the patients ranged from 20 years old to 55 years old. The size of the flap ranged from 1x1.5 cm to 8.5x2.5 cm. The mean flap area was 5.4 cm2. In 4 cases, we elevated the flap including lateral aspect of the big toe and medial aspect of the second toe. And then we made an artificial syndactyly to reconstruct the pulps on two fingers at the same time. In all cases, we performed 1 digital artery and 1 dorsal vein anastomosis. Every donor site that had a small defect healed spontaneously without any additional operations to cover it.
Results: Of this type of surgery 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. There was no severe complication in the donor sites. There was no walking disturbance due to the skin defect of the donor site. The static 2 point discrimination in 11 cases that we could check ranged from 3 mm to 15 mm.
Conclusion: The authors believe that the first web space free flap of the foot is a good option for the reconstruction of the pulp of the fingers and it has a minimal donor site morbidity.

Key Words: Pulp, First web sapce free flap