Background The introduction of the partial second toe pulp free flap has enabled superior aesthetic
and functional results for fingertip reconstruction in adults. Children undergoing
fingertip amputation for various reasons have limited options for reconstruction.
Conventional treatment could shorten the finger, leading to poor cosmesis and function.
We report 18 years of our experiences with fingertip reconstruction using partial
second toe pulp free flaps in patients in early childhood.
Methods Medical charts of children who had undergone fingertip reconstruction using partial
second toe pulp free flaps from 2001 to 2018 were retrospectively reviewed. The surgical
procedures were identical to those for adults, except for the usage of 11-0 nylon
sutures. Patients’ demographic data, vessel size, flap dimensions, length of the distal
phalanx, and functional outcomes over the course of long-term follow-up were documented.
The statistical analysis was performed with the Student t-test, the Mann-Whitney U
test, and Pearson correlation analysis.
Results Eighteen toe pulp flaps in 17 patients (mean age, 3.0 years) were identified. All
the flaps survived without any major complications. In long-term follow-up, the flap-covered
distal phalanges showed growth in line with regular development. There was no donor-site
morbidity, and all children adapted to daily life without any problems. In two-point
discrimination tests, the fingertip sensation recovered to almost the same level as
that in the contralateral finger.
Conclusions Partial second toe pulp free flaps are an excellent option for fingertip reconstruction
in young children, as well as in adults.
Keywords
Free tissue transfer flaps - Childhood - Fingertip - Reconstructive surgical procedure
