Combined bilateral toe flaps for repair of the multi-finger degloving injury at one stage / 中国矫形外科杂志

ABSTRACT

[Objective]To inrestigate the clinical outcomes of using bilateral tibial flap of the second toe nail flap combined with the fibulal flap of the big toe to repair the multi-finger degloving injury.[Method]A variety of different methods were used to repair the multi-finger degloving injury,six fingers in 3 cases were repaired by partial bilateral wrap-around flaps combined with the tibial flap of the second toe.Sixteen fingers in 8 cases were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe.Six fingers in 2 cases were repaired by bilateral second toenail flap,the fibulal flap of the big toe and the digital arterial island flap.Three fingers in l case were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe and the the lateral flap of dorsum of foot.Six fingers in 3 cases were repaired by bilateral second toe nail flap and the fibulal flap of the big toe and bilateral dorsum flap of foot.Four fingers in 1 case were repaired by partial bilateral wrap-around flaps and the tibial flap of the second toe and the anterolateral thigh flap.Six fingers in 3 cases were repaired by bilateral second toe nail flap combined with the fibulal flap of the big toe,and bilateral dorsum flap of foot and bilateral anterolateral thigh flap.[Result]Ninety-seven flaps of 98 flaps of 47 fingers in 21 cases were suvived well,with 1 flap developed necrosis.The follow-up duration ranged from 6 months to 9 years in 17 cases (37 fingers).In addition to the activities of DIP limited,the other interphalangeal joint activities were nearly normal.All of the fingernail grew well.Two point discrimination of the fingers was between 5mm and 11 mm.The donor site was hardly affected.[Conclusion]It is a better method using the big toe flap combined with the second toe flap to repair the the multi-finger degloving injury at one stage.