Salvage of free second toe with venous thrombosis by shunting retrograde arterial flow of second dorsal metatarsal artery.

Although there are case reports about salvaging amputated digits without venous return by shunting retrograde blood flow from a distal digital artery to a proximal vein (Smith et al., Plast Reconstr Surg 71:52, 1983), successful salvage of a congested free toe with efferent arteriovenous (AV) shunting retrograde arterial flow from the second dorsal metatarsal artery (SDMA) has never been reported. In this paper, we describe the possible factors for venous thrombosis, the errors we committed in the operation, and how the free toe can survive without venous drainage.