PUBLISHED ONJanuary 04, 2014 1:00 AM
When the second toe is sizable, matching the size of the thumb, it is the best option for thumb reconstruction.
Harvesting technique
1. The length of the reconstructed thumb is decided by measuring the thumb on the other hand.
With the help of x-rays, the proposed surgical cutting on the second toe is marked.
The skin flaps on the upper side and sole of the foot are marked with a V-shape so it's easier to close up the cut later.
The upper side incision is an S- shape, and the incision in the sole is curved and angulated, avoiding the weight-bearing area.
2. The branches of the deep peroneal nerve (DPN) to the big toe, which is responsible for the lifting of the toe and ankle, are preserved.
The nerves and extensor and flexor tendons are dissected to required lengths. On the sole, some fat and tissue are discarded under the skin to reduce bulk and facilitate knuckle motion in the transferred toe.
If a long nerve segment is needed, the common digital nerves to the first and third toes are split.
3. All the structures except the pedicle (a small stalk-like structure connecting an organ or other part to the human body) are divided carefully.
Later, the tourniquet is released to allow restoration of blood flow to the toe.
Source: TTSH
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