Abstract:

Objective　To provide the anatomical basis for free hallux chimeric 2nd toe nail skin flap for composite tissue flap for thumb reconstruction.　Methods　10 fresh cadaveric foot specimens were dissected after perfusion with red latex. Systematic observation of hallux toe and 2nd toe arterial and venous distribution was performed, and  the length and diameter were measured; Free hallux chimeric 2nd toe nail skin flap composite tissue flap for thumb operation design was simulated.　Results　1st dorsal metatarsal artery in the 1th toes web space deep issued 2nd branches: the lateral plantar proper artery of Hallux the medial plantar proper artery of the second toe. The lateral plantar proper artery of Hallux (Bifurcation into the flap) has a length of (1.82±0.12) cm, anda  diameter of (1.08±0.06) mm; The medial plantar proper artery of the second toe has a length of (0.90±0.16) cm and diameter of (0.82±0.13) mm. Veins were located in  two layers. The 1st and 2nd dorsal superficial veins drain into the saphenous vein at the medial aspect of the foot and ankle. The reconstructed thumb's vascular pedicle underwent no compression.　Conclusions　The arterial and venous vessels of the 1st and 2nd toes can provide the hallux 2nd toe nail skin flap and 2nd toe of composite tissue flap with blood supply. No compression will occur in the reconstructed thumb’s vascular pedicle. Suitable for design free hallux chimeric 2nd toe nail skin flap composite tissue flap for thumb.

Key words: Hallux nail flap, Chimeric tissue flap, 2nd toe, Microscopic anatomy