The foot offers numerous useful options for hand reconstruction. Hallux transfer, dorsalis pedis flap, second toe transfers, and toe joint transfers offer good functional results in reconstructed hands. However, when the donor site is repaired with skin grafts, delayed wound healing, scarring, and contractures often result. Poor cosmesis of the donor site and altered gait are the main drawbacks of the procedures. The authors propose a new concept of primary reconstruction of the donor foot using a reverse-flow anterior tibial flap from the same leg. Two flaps are raised from the same anterior tibial vessel system in continuity as a distal free flap for hand reconstruction and as a proximal reverse-flow pedicled flap to resurface the donor defect. This technique allows good flap reconstruction of the foot donor site, reducing morbidity and limiting the operation to the same limb. The authors report their experience of 33 cases. There were no failures. Primary wound healing was achieved in the foot donor site, with acceptable cosmesis and satisfactory function.
Shanghai, People’s Republic of China; and Singapore
From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Second Medical University, and Departments of Hand and Reconstructive Microsurgery and Orthopaedic Surgery, National University of Singapore.
Received for publication August 12, 2002;
revised December 10, 2002.
Yeong Pin Peng, F.R.C.S.
Department of Hand and Reconstructive Microsurgery
National University Hospital
5 Lower Kent Ridge Road