AESTHETIC FINGERTIP RECONSTRUCTION WITH A FREE VASCULARIZED NAIL GRAFT - A REVIEW OF 60 FLAPS INVOLVING PARTIAL TOE TRANSFERS

Microsurgical toe transfer is an established procedure for functional reconstruction of fingers. However, even if the functional loss is min imal, the fingertip defect is often a large problem for patients for n ot only functional reasons but also aesthetic reasons. In these patien ts, although the normal appearance of the fingertip is very important, total toe transfer is not acceptable because of resection of an entir e toe. With this background, partial toe transfer techniques have grea tly progressed. On the other hand, various types of innervated finger flaps also have been developed in hand surgery. Based on this progress , we developed the combined technique of innervated finger flaps in th e hand and osteo-onychocutaneous flaps from the toe. This technique pr ovides better aesthetic results in fingertip reconstruction, thus broa dening the indications for vascularized nail grafts. We have now exper ienced 60 flaps in par tial toe transfer. In this report, a review of 60 consecutive flaps is presented, and the indications, technique, and postoperative treatment are discussed.