Abstract：Objective To investigate the effect of free toe transplantation in finger reconstruction.Methods Free toe transplantations were performed in 164 patients (185 fingers) suffering from finger defection.There were 134 males and 30 females,aged at 12-83 years [mean (44.8 ± 11.2)years].Finger deletion severity was classified as grade Ⅰ in one case,grade Ⅱ in 18,grade Ⅲ in 23,grade Ⅳ in 49,grade Ⅴ in 54,and grade Ⅵ in 19.According to Gilbert standards,dorsal metatarsal arteries were classified as type Ⅰ in 68 cases,type Ⅱ in 84,and type Ⅲ in 12.Survival ratio of the transplanted fingers and hand function rehabilitation were observed.Results The transplanted toe survived in 160 cases (173 fingers).They composed of all the cases of grade Ⅰ-Ⅴ finger deletion and 15 cases of grade Ⅵ finger deletion; all the cases of type Ⅰ dorsal metatarsal arteries,83 cases of type Ⅱ dorsal metatarsal arteries and nine case of type Ⅲ dorsal metatarsal arteries.Transplantation failed in four cases (12 fingers) of grade Ⅵ finger defection including one case of Gilbert Ⅱ dorsal metatarsal arteries and three cases of Gilbert Ⅱ dorsal metatarsal arteries.Postoperative results were excellent in 110 cases and good in 50.Conclusions Toe transplantation is helpful to restore the finger shape and function and the outcome is satisfactory.Anatomic deformation of dorsal metatarsal arteries is the main cause for the failure of finger reconstruction.
［1］Kotkansalo T, Vilkki S, Elo P. Long-term results of finger reconstruction with microvascular toe transfers after trauma. J Plast Reconstr Aesthet Surg, 2011, 64(10):1291-1299.
［5］Gilbert A．Composite tissue transfers from the foot: anatomic basis and surgical technique. Symposium on Microsurgery. St Louis: Mosby, 1976, 14: 230-241.
［7］Zhang J, Xie Z, Lei Y, et al. Free second toe one-stage-plasty and transfer for thumb or finger reconstruction. Microsurgery, 2008, 28(1):25-31.
［8］Brunelli F, Spalvieri C, Rocchi L, et al. Reconstruction of the distal finger with partial second toe transfers by means of an exteriorised pedicle. J Hand Surg Eur Vol, 2008, 33(4):457-461.
［9］Zongyuan J, Lei X, Li C, et al. The growth potential in second-toe transfers for reconstruction of traumatic thumb and finger amputations in children. Plast Reconstr Surg, 2012, 129(1):206e-208e.
［10］Wallace CG, Wei FC. Posttraumatic finger reconstruction with microsurgical transplantation of toes. Hand Clin, 2007, 23(1):117-128.
［11］Goiato MC, Mancuso DN, Marques Ferreira P, et al. Finger prosthesis: the art of reconstruction. J Coll Physicians Surg Pak, 2009, 19(10):670-671.
