Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers
A 19-year-old man presented to the ER with a roller press injury to the right ring finger. Examination of the injured finger revealed a 1.5×2.5 cm volar soft tissue defect over the middle phalanx with accompanying loss of the radial neurovascular bundle (). An emergency single-stage reconstruction was performed. An immediate second toe plantar free flap was performed with the incorporation of the plantar digital nerve as a bridge conduit between the severed ends of the digital nerve (). The donor site was closed with a full thickness graft (). Postoperatively, the flap showed good circulation ().\nAt the 9-month follow-up visit, static and dynamic two-point discrimination of the involved fingertip was normal at 3 mm. The Semmes-Weinstein monofilament test showed the injured area to have tactile resolution which equaled that of the non-injured finger on the contralateral side. The range of motion in the involved joint was comparable to the contralateral digit. The flap was similar in shape and color to the surrounding tissue ().