Clinical analysis of free fibular skin flap of great toe for repair of finger flexion deformity due to scar contracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Kuankuan ,  WU Min , HAN Zhongbing , NIU Haizhou , LIU Yangyang , GAO Xubin , ZHU Jun , LIU Fendou , DING Zhenfei

Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical University, Bengbu Anhui, 233000, P. R. China;

Corresponding?author：

WU Min, Email: wumin200207@163.com

Keywords：

Fibular skin flap of great toe; scar contracture; flexion deformity; finger joint; microsurgery

DOI：

10.7507/1002-1892.202603054

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Objective To investigate the effectiveness of the free fibular skin flap of the great toe in repairing finger flexion deformity due to scar contracture. Methods The clinical data of 12 patients with finger flexion deformity due to scar contracture treated with scar release and free fibular skin flap of the great toe between March 2022 and December 2024 was retrospectively analyzed. All patients had flexion deformity caused by scar contracture of finger joints after healing of skin defect scar. The duration of scar contracture ranged from 3 months to 2 years, with an average of 7 months. The active range of motion of the finger joint was 0°-10°, with an average of 8°. The range of skin flap was 2.0 cm×1.3 cm to 3.5 cm×2.5 cm. Results All 12 patients were followed up 6-12 months, with an average of 10.5 months. At last follow-up, the flexion deformity of the affected finger was completely corrected, and the active range of motion of the finger joint was restored to close to the healthy side (the distal finger joint was 30°-40°, with an average of 35°; the proximal finger joint was 80°-90°, with an average of 85°). The shape of the flap was plump, the texture was good, and the static two-point discrimination was 6-8 mm, with an average of 6.8 mm. According to the evaluation standard of upper limb function of Chinese Medical Association Hand Surgery Society, 9 cases were excellent, 3 cases were good, and the excellent and good rate was 100%. All wounds at donor sites healed by first intention, with no pain, ulcer or ulceration in toes, normal walking in shoes, and no influence on gait. Conclusion Free fibular skin flap of the great toe is an effective method to repair the finger flexion deformity due to scar contracture, which providing good cosmetic, motor, and sensory outcomes with low donor-site morbidity.

Citation： ZHANG Kuankuan, WU Min, HAN Zhongbing, NIU Haizhou, LIU Yangyang, GAO Xubin, ZHU Jun, LIU Fendou, DING Zhenfei. Clinical analysis of free fibular skin flap of great toe for repair of finger flexion deformity due to scar contracture. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(8): 1254-1257. doi: 10.7507/1002-1892.202603054 Copy

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10.	殷建偉, 常強省. 游離趾腓側瓣與指背島狀皮瓣在手指末節指腹缺損修復中的應用對比[J]. 臨床研究, 2025, 33(1): 21-24.
11.	吳凡, 張乃臣, 張文忠, 等. 手指瘢痕攣縮治療的再認識[J]. 實用手外科雜志, 2022, 36(2): 256-258.
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1. 路訓平. 手指瘢痕攣縮屈曲嚴重畸形的矯形治療研究[J]. 中國矯形外科雜志, 2016, 24(16): 1521-1523.
2. 許生領, 魏龍雨, 張浩, 等. 拇趾腓側皮瓣游離移植修復手指末端指腹缺損的效果觀察[J]. 中國美容醫學, 2025, 34(4): 47-50.
3. 潘生德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準[J]. 中華手外科雜志, 2000, 16(3): 130-135.
4. 劉亦楊, 沈立鋒, 林炳遠, 等. 游離踇趾腓側皮瓣移植修復兒童手部創傷性軟組織缺損[J]. 中華小兒外科雜志, 2020, 41(3): 262-267.
5. 李忠文, 湯浩, 唐懷龍, 等. 游離踇趾腓側瓣與腕橫紋皮瓣橋接修復伴指動脈及神經缺損手指創面的療效比較[J]. 實用手外科雜志, 2023, 37(4): 503-506, 518.
6. 肖湘君, 劉鳴江, 廖輝文, 等. 游離踇趾甲皮瓣嵌合第2趾骨復合組織瓣再造拇指的顯微外科解剖[J]. 中國臨床解剖學雜志, 2017, 35(3): 245-248.
7. 薛亞軍, 尹建云, 王紅兵, 等. 游離踇趾腓側皮瓣修復指腹缺損的臨床療效[J]. 實用手外科雜志, 2023, 37(1): 138-139.
8. Brutus JP, Taylor A, Barone N, et al. Extensor mechanism dysfunction and hand deformities caused by Dupuytren’s disease: Surgical and rehabilitation perspectives[J]. J Hand Ther, 2025, 38(3): 566-573.
9. Moungoundo F, Moussa MK, Schuind F. Percutaneous sonography-guided treatment of Dupuytren contracture under liquid immersion. Case reports[J/OL]. Int J Surg Case Rep, 2025, 126: 110684. doi: 10.1016/j.ijscr.2024.110684.
10. 殷建偉, 常強省. 游離趾腓側瓣與指背島狀皮瓣在手指末節指腹缺損修復中的應用對比[J]. 臨床研究, 2025, 33(1): 21-24.
11. 吳凡, 張乃臣, 張文忠, 等. 手指瘢痕攣縮治療的再認識[J]. 實用手外科雜志, 2022, 36(2): 256-258.
12. 劉會軍, 楊勇, 謝山洪, 等. 改良切口切取以甲緣靜脈-趾背靜脈回流的踇趾腓側皮瓣修復手指指腹創面[J]. 中華手外科雜志, 2024, 40(5): 401-404.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical analysis of free fibular skin flap of great toe for repair of finger flexion deformity due to scar contracture

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