An Extraordinary Reconstruction of a Postoperative Defect after Metatarsophalangeal Joint Arthrodesis of the Big Toe Using the "Chinese Forearm Flap".

[BACKGROUND] We present an unusual technique for reconstruction of a postoperative tissue defect following hallux rigidus surgery.

[METHODS] A complicated course after left big toe arthrodesis resulted in a soft tissue defect with bone exposure of the first ray. Amputation of the big toe was categorically rejected by the patient. There was advanced arteriosclerosis with single-vessel supply to the foot via the posterior tibial artery.

[OUTCOME] To preserve the big toe, the defect was covered by a fasciocutaneous radial free flap with a 15 cm long vascular pedicle which was microanastomosed to the posterior tibial artery and its accompanying vein at the level of the medial malleolus.

[CONCLUSION] In certain extreme situations, the free "Chinese" radial flap can be quite effective in covering forefoot defects and allowing satisfactory and aesthetically pleasing soft tissue reconstruction.