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Necrosis of skin on the medical side of the great toe has been a significant complication of the great toe nail flap.
To investigate the reason for this, a study of the blood supply of the medial side of the great toe was carried out on 55 feet with the injection of red latex into the arteries and on 13 vascular cast specimens. It was found that, after the blood vessels from the plantar and dorsal sides of the great toe are severed during the operation, the skin of the medial side of the great toe is mainly supplied by the medial vascular network at the head of the first metatarsal bone. It is clear that the blood supply from this network may sometimes be insufficient to nourish the skin. It is suggested that the operative incision should be changed so as to increase the blood supply to the medial vascular network which may decrease the incidence of skin necrosis.
- Application of big toe nail flap in reconstruction of the thumb.Chinese Journal of Surgery. 1982; 20: 707
- Emergency reconstruction of thumb and finger.Medical Journal of Chinese People's Liberation Army. 1984; 9: 30
- Composite tissue transfers from the foot; Anatomic basis and surgical technique.in: Symposium on Microsurgery. Vol. 14. C. V. Mosby Co.,, St Louis1976
- Microvascular segmental thumb reconstruction: A case report.British Journal of Plastic Surgery. 1980; 33: 64
- The use of free toe-nail flap in the repair of severe avulsion injury of the thumb.Chinese Journal of Orthopedics. 1985; 3: 153
- Reconstruction of the thumb with free neurovascular skin flap from the big toe and frozen bone-joint-tendon composite allograft (Report of 132 cases).Chinese Journal of Microsurgery. 1986; 9: 5
- Reconstruction of the thumb and finger with free toe graft.Medical Journal of Chinese Navy. 1983; 1: 28
- Surgical anatomy of the first plantar metatarsal artery.Chinese Journal of Clinical Anatomy. 1986; 4: 65
- Reconstruction of the thumb with free great toe-nail flap (Report on 12 cases).National Medical Journal of China. 1983; 63: 750
- Restoration of the thumb by free big toe-nail skin flap with microvascular anastomosis.Chinese Journal of Orthopedics. 1984; 4: 194
- Cause of skin necrosis after resection of great toe-nail flap.Chinese Journal of Microsurgery. 1985; 4: 207
This work was supported by a research grant from the University.
© 1987 The Trustees of British Association of Plastic Surgeons. All rights reserved. Published by Elsevier Inc.