The dorsal approach in harvesting the second toe

Area of Science:

• Orthopedic Surgery
• Vascular Surgery
• Microsurgery

Background:

• Direct access to plantar structures of the second toe is crucial for reconstruction.
• Improving toe blood supply is a key challenge in reconstructive surgery.

Purpose of the Study:

• To describe a novel dorsal approach for toe reconstruction.
• To evaluate the efficacy of a "multiple set arterial transfer" technique.
• To assess the safety and functional outcomes of the procedure.

Main Methods:

• A dorsal approach involving early section of the second metatarsal bone.
• Implementation of a "multiple set arterial transfer" for enhanced vascularity.
• Early ambulation protocol initiated on the fifth postoperative day.

Main Results:

• Direct access to plantar arteries, nerves, and flexor tendons of the second toe was achieved.
• The arterial transfer technique successfully improved toe blood supply.
• No vascular complications were observed in microvascular reconstructions after postoperative day five.
• Early walking was feasible and well-tolerated.

Conclusions:

• The described dorsal approach and arterial transfer technique offer a viable method for toe reconstruction.
• This approach facilitates improved toe vascularity and allows for early patient mobilization.
• The procedure demonstrates a favorable safety profile with no reported vascular complications.