Reconstruction of radial half hand by using combined transplantation of pedicled phalanx, free toe, and island flap.

Combined transplantation of 1) a residual proximal phalanx flap of the thumb with a fascial pedicle, 2) a reversed island flap based on the posterior interosseous artery, and 3) a free second toe was successfully used to reconstruct the radial half of the hand in a patient who had experienced loss of the second metacarpal bone and index finger, a defect to the shaft of the third metacarpal bone, and dry gangrene of the thumb, two-thirds of the radial dorsal skin and the first web space of the left hand. The reconstructive result was satisfactory and took advantage of each tissue flap. The operation was relatively simple and was completed in one stage. We believe the procedure provided good recovery of function and appearance at an appropriate cost.