Abstract:

Objective　 To explore the feasibility of combined the free wrap-around flap of the ipsilateral big toe and the fibular flap of the contralateral big toe intreating degloved  injuries  of the thumb.　Methods  Eighteen right thumbs of fresh cadaver specimens were  modeled to degloved injuries of thumbs. Wound surfaces of the thumb were divided into two parts : the dorsal aspect and the plantar aspect, measurement of the vertical length of the dorsal and plantar aspects and proximal circumference of the wound surfaces was carried out, with obtained data recorded.Then dorsal wound of the models of degloved injuries of the thumbs was covered with wrap-around flaps of theipsilateral big toes and palm wound  was covered by fibular flaps of the contralateral big toes.　Results　Among the measurement data of 36 models of degloved injuries of thethumbs,the largest vertical length of the dorsal aspect was 6.2cm, the plantar aspect 5.9cm and proximal circumference was 6.9 cm. All data above-mentioned were smaller than themaximum reported in the literature. Degloved juries of the right thumbs were repaired with combined free wrap-around flaps of the ipsilateral big toes and fibular flaps of thecontralateral big toes in 18 cases of surgical simulation，and the appearances were satisfactory and similar to the that of the contralateral normal thumbs.　Conclusion　Boththe wrap-around flapof the big toe and the fibular flap of the big toe can respectively provide a large enough flap to cover the wound surface of dorsal and volar surfaces ofthe thumb. The surgical approach of the combined free wrap-around flap of the ipsilateral big toe and the fibular flap of the contralateral big toe in treatment of deglovedjuries of the thumb is feasible.

Key words: Thumbs, Toes, Degloved injuries, Suexploregical flaps