Wang KL, Zhang ZQ, Buckwalter JA, Yang Y. Supermicrosurgery in fingertip defects-split tibial flap of the second toe to reconstruct multiple fingertip defects: A case report. World J Clin Cases 2019; 7(17): 2562-2566 [PMID: 31559293 DOI: 10.12998/wjcc.v7.i17.2562]
Corresponding Author of This Article
Yi Yang, MD, PHD, Surgeon, Department of Microsurgery and Orthopedic Trauma, the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, Guangdong Province, China. 270382272@qq.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2019; 7(17): 2562-2566 Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2562
Supermicrosurgery in fingertip defects-split tibial flap of the second toe to reconstruct multiple fingertip defects: A case report
Ke-Lie Wang, Zi-Qing Zhang, Joseph A Buckwalter, Yi Yang
Ke-Lie Wang, Zi-Qing Zhang, Department of Microsurgery and Hand Surgery, the Longgang Orthopedics Hospital of Shenzhen, Shenzhen 518116, Guangdong Province, China
Joseph A Buckwalter, Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA 52240, United States
Yi Yang, Department of Microsurgery and Orthopedic Trauma, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Author contributions: Wang KL, Zhang ZQ and Yang Y were responsible for conception and design, acquisition of data and drafting the article and performed the surgery; Buckwalter JA revised the article.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yi Yang, MD, PHD, Surgeon, Department of Microsurgery and Orthopedic Trauma, the First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou 510080, Guangdong Province, China. 270382272@qq.com
Telephone: +86-20-28823388 Fax: +86-20-28823388
Received: March 29, 2019 Peer-review started: April 4, 2019 First decision: June 19, 2019 Revised: June 27, 2019 Accepted: July 20, 2019 Article in press: July 20, 2019 Published online: September 6, 2019 Processing time: 161 Days and 18.5 Hours
Abstract
BACKGROUND
Injuries to multiple fingertips pose a significant treatment dilemma. Numerous reconstructive options exist, all with the ultimate goal of restoring function and sensibility to the injured fingertips.
CASE SUMMARY
A 24-year-old male suffered injury to multiple fingertips of the right hand, resulting in exposed distal phalanges of the middle, ring, and small fingers. The amputated distal stumps were not possible for replantation. Free flap coverage was selected in order to achieve better functional outcome. The fingertip defects were covered by performing a right second toe split tibial flap using local anesthesia at the harvest site and brachial plexus nerve block for the right upper extremity. At 6-month follow-up, all three of the reconstructed fingertips had some preserved nail growth, Semmes-Weinstein Monofilaments testing was equal to the contralateral side and the Static Two-Point Discrimination were comparable to the contralateral side.
CONCLUSION
This report provides a novel reconstructive option for the management of multiple fingertip injuries and demonstrates the utility of supermicrosurgery in management of these injuries.
Core tip: Injuries to multiple fingertips pose a significant treatment dilemma. Numerous reconstructive options exist, all with the ultimate goal of restoring function and sensibility to the injured fingertips. We present a case of a split tibial flap of the second toe utilized to treat multiple fingertip injuries, resulting in satisfactory restoration of function and sensation. This report provides a novel reconstructive option for the management of multiple fingertip injuries and demonstrates the utility of supermicrosurgery in management of these injuries.
