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Cosmetic Reconstruction of Fingertips Using Free Micro-toe Tissue Flaps With Exclusive Arterial Blood Supply
Linhai Liu1,2, Fangling Shi1,2, Lingfeng He1,2
1From the Department of Hand Microsurgery and Plastic Reconstructive Surgery, Ningbo No.6 Hospital, Ningbo, Zhejiang, China.
Plastic and Reconstructive Surgery. Global Open
|March 9, 2026
Summary
This study presents a novel cosmetic reconstruction technique for fingertip defects using free toe tissue flaps with arterial supply only. This simplified approach demonstrates clinical safety and feasibility, reducing surgical complexity and operation time.
Area of Science:
- Microsurgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Free tissue flap transfer typically necessitates both arterial and venous anastomosis.
- Venous repair in tiny tissue reconstruction is challenging due to recipient site trauma or scar contracture.
- A novel technique using micro-toe flaps with arterial anastomosis only is presented.
Purpose of the Study:
- To evaluate the efficacy and safety of free toe tissue transfer relying solely on arterial blood supply for fingertip cosmetic reconstruction.
- To explore a simplified approach to reconstructive surgery for distal finger soft tissue defects.
Main Methods:
- Cosmetic reconstruction of fingertip defects in 13 patients using free-toe tissue transfer.
- Flaps were designed based on defect location and size, sourced from the great toe.
- The reconstruction exclusively utilized arterial blood supply, omitting venous anastomosis.
Main Results:
- All 13 free toe tissue flaps achieved successful survival.
- Post-operative follow-up revealed good flap texture and sensation (2-point discrimination 4-8 mm).
- Average flap weight was 2.8g, with functional outcomes assessed by the Quick Disabilities of the Arm, Shoulder and Hand score (average 5.29).
Conclusions:
- Free toe tissue flaps with arterial supply only are clinically safe and feasible for finger soft tissue defect repair.
- This technique maintains surgical efficacy while reducing procedure complexity and operative duration.
- The study highlights a viable alternative to traditional flap procedures requiring venous anastomosis.
