Bilateral Multiple Fingertip Reconstruction with Free Medialis Pedis Flaps for Treating Frostbitten Fingertips

A Case Report

Abstract

Fingertip reconstruction requires flap transplantation rather than a skin graft. Depending on the amputation level, or the lack of volar side, palmar side, or nail matrix, surgeons can consider some surgical strategies for the reconstruction of a single fingertip, and various flap-implantation methods have been reported. However, there are few reports describing multiple fingertip reconstructions. This case report describes a 55-year-old man diagnosed with bilateral multiple fingertip necrosis caused by frostbite. A multiple fingertip salvage procedure with a piece of free medialis pedis flap was performed for the non-dominant left hand, and the donor site was transplanted with an artificial dermis. Three weeks later, the flap was cut to separate the fingers, and a full-thickness skin graft taken from the left inguinal region was transplanted to the donor site. Subsequently, the same procedure was performed for the dominant hand. The course of treatment allowed the patient to return to his original job with minimal hand dysfunction. The outcomes were functionally and aesthetically satisfactory, and no additional surgery such as debulking was required. This report showed the usefulness of a free medialis pedis flap for multiple fingertip reconstruction.