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Published on: December 5, 2025
Post-traumatic big toe reconstruction using free flaps
Atsushi Yoshida1, Hiroshi Yajima, Keiichi Murata
1Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan.
Journal of Reconstructive Microsurgery
|June 20, 2006
Summary
Reconstructing big toe defects is crucial for stability and gait. This study shows free flaps, including peroneal and scapular flaps, offer successful reconstruction for big toe defects, restoring function and appearance.
Area of Science:
- Orthopedics
- Plastic Surgery
- Reconstructive Surgery
Background:
- The big toe is vital for stability and gait.
- Reconstruction of big toe defects is infrequently reported.
- Metatarsophalangeal (MTP) joint integrity is essential for big toe function.
Observation:
- Seven male patients with big toe defects underwent reconstruction.
- Free peroneal flaps (n=5) and free scapular flaps (n=2) were utilized.
- Flap sizes varied from 9x4 cm to 24x6 cm, with iliac or scapular bone grafting.
Findings:
- Six of seven flaps survived completely, achieving bone union within 3 months.
- One flap experienced partial necrosis due to arterial thrombosis.
- All patients returned to their previous occupations with acceptable cosmetic outcomes.
Implications:
- Free flap reconstruction is a viable option for significant big toe defects.
- Successful reconstruction restores patient function and improves quality of life.
- Further research may optimize flap selection and surgical techniques for big toe reconstruction.