Salvage in a case of ring avulsion injury with an immediate second-toe wrap-around flap

A nonreplantable complete degloving injury to the small finger of a young woman was treated with the immediate microsurgical transfer of a second-toe wrap-around flap. One year after the operation, the donor foot was free of symptoms, and the reconstructed finger had an excellent cosmetic appearance, a range of motion of 0/90 degrees at both the metacarpophalangeal and the proximal interphalangeal joints, and a two-point discrimination of 6 mm. In selected patients, when the degloved skin envelope cannot be revascularized and when the skeletal and tendinous units are still intact, an immediate second-toe wrap-around flap may be a good alternative to amputation.