Abstract:

Objective　To offer anatomic basis for thumb reconstruction by transferring modified great toe nail-skin flap and second toe.  Methods　20 adult cadaveric feet perfused with emulsion were microdissected and observed blood supply of great toe skin-nail flap and second toe compound flap. Results　There were different blood origin for great toe skin-nail flap, mainly from plantar digital artery on fibular side of 1st toe and hallucis dorsal digital artery, with the diameters of (1.5±0.3)mm and (0.9±0.2)mm respectively. The vein drained into the great saphenous vein from the 1st dorsal metararsal vein and dorsal digital vein on fibular side of 1st; The nerve was the branches of the deep peroneal nerve and fibular marginal plantar digital nerve of 1st. For free composite tissue flap of second toe, its arteries were mainly from dorsal artery on fibular side of 2st toe and dorsal digital artery of 2st, with the diamaters of (0.7±0.1)mm and (0.3±0.1)mm respectively, while, its veins drained into the great saphenous vein from the 1st dorsal metararsal vein and the dorsal digital vein on tibial side of 2st, and its nerve was the branches of the tibial marginal plantar digital nerve of 2st.   Conclusions   Plantar digital artery on fibular side of 1st toe, hallucis dorsal digital artery, the dorsal artery on fibular side of 2st toe and dorsal digital artery of 2st will provide ideal blood supply for thumb reconstruction adopting modified the second toe and great toe skin-nail flap, for its wide diameter, extensive and plenty of cutaneous branches.

Key words: Great toe skin-nail flap, Second toe, Transplantation, Reconstruction, Applied anatomy