Abstract: Objective： To investigate the validity and the outcome of a new surgery method that utilizes lateral great toe flap to decoratively reconstruct the thumb pulp loss. Methods: From Jan. 2009 to Jan. 2014, 22 cases with unilateral thumb pulp defect were included, for whom, lateral great toe flap was deployed to reconstruct the thumb. Blood circulation was re-established by the anastomosis of the digital vessels of toes and fingers in 18 cases, the other 4 cases were conducted by a dorsal metatarsal artery and vein anastomosed to the deep branch of the radial artery and the dorsal metacarpal vein respectively; as for the nerve repair, toe-to-finger digital nerve anastomosis was performed. The donor sites were covered by full-thickness inguinal skin grafts. Results: All the 22 flaps survived without complications. With 6 to 12 months follow-up, the surviving fingers all presented aesthetically pleasant appearance with vivid loops and whorls. Normal functions like sweating were restored as well, and the two-point-discrimination ranged 3.0 to 6.0 mm (4.2 mm in average). The skin grafts to the donor sites healed uneventfully, the appearance and functions of the feet were unaffected. Conclusion: Lateral toe flap should be the first-line choice for reconstructing thumb defect, as it conveniently restores both functions and outlook.

Key words: Thumb, Finger injuries, Toes, Surgical flaps, Reconstructive surgical procedures