Reverse radial forearm flap as a source of soft tissue and blood supply for thumb reconstruction

Soft-tissue deficiency is sometimes a major problem in thumb reconstructive cases with toe-to-thumb transfer. In the patient presented, a reverse radi al forearm flap was used to provide a vascular pedicle far anastomosis with the second toe vessels. The flap also provided soft-tissue coverage for th e metatarsal bone of the transferred toe. The radial artery and concomitant vein were used for the dorsalis pedis artery and vein anastomosis, The ski n island of the forearm flap was wrapped around the transferred metatarsal bone. Using this technique, two limiting problems in toe-to-hand transfers were solved at the same time, In the crushed hand, sometimes it is not poss ible to find enough soft tissue and a good vascular pedicle for a new thumb , and this option seems to be a reasonable choice.