Practical Techniques in Flap Surgery by Yuichi Hirase

Author:Yuichi Hirase
Language: eng
Format: epub
Publisher: Springer Japan, Tokyo

Note

In consideration of combining with the flap on the finger, a zigzag pattern is used along the margin.

Fig. 10.30Procedure 4: The digital toe artery (or dorsal/plantar metatarsal artery), digital toe nerve, and subcutaneous veins of the flap are secured, proceeding from the first web space

Fig. 10.31Procedure 5: The distal phalanx is divided from the toe tip, with 1/3 of the bone attached to the flap

Note

In this situation, pay attention not to break the bone in the area that connects with the nail matrix. In the case that it is difficult to attach to the flap, it is possible to harvest by amputating up to the IP joint, however it is necessary to remove the projecting portion of the distal end of the proximal phalanx bone, return the collateral ligament to its original position and suture the surrounding area.

For the attachment section of the extensor pollicis longus muscle tendon, be careful not to sever the tendon.

Fig. 10.32Procedure 6: The nail flap with short pedicle artery, vein and nerve attached is harvested

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