[Free toe transfer with plantar metatarsal arteries and dorsal venous pedicle. Report of 18 cases].

Eighteen free second toe were used for pollicization other than the conventional method. From the first and second plantar metatarsal arteries junction of the both digital arteries of the second toe were dissected retrogradely and anastomosed to the deep of superficial palmar arch or terminal branch of the radial artery. The venous return was established between the dorsal venous arch and cephalic vein. These vessels were found to have much bigger diameters and less anatomical variation than those used by conventional methods. Seventeen transplantation were considered successful both functionally and cosmetically. One cases had persistent spasmodic contraction of the recipient arteries, so the transplant was salvaged by subclavicular pedicle including the sutured nerves and the attached soft tissues as introduced by Lu in 1964. Our method for reconstruction of the thumb or finger can avoid frequent anatomical variation and smaller diameter of the anastomosed vessels.