Reconstruction of the great toe in a child using the Y-V pedicle elongation technique for a medial plantar flap

The authors report a case of reconstruction of a great toe in a young boy, following amputation proximal to the IP joint and exposure of the MP joint. A local flap was chosen for its lesser morbidity, and plantar skin was selected as optimal coverage for weight-bearing surfaces on the first ray. Very few local flaps fulfill these conditions. The Y-V technique of elongation of a vascular pedicle, first described by Martin in 1991, was used to bring a medial plantar flap to the toe, doubling its normal arc of rotation distally. Technical points are highlighted and outcome is reported at 18 months follow-up.