Second Toe Free Flap

The second toe flap is described in this chapter for both traumatic hand injuries and in children with congenital differences. The authors describe the anatomy, variations in blood supply and a stepwise guide in elevation of this flap. The donor morbidity of the second toe flap is far more acceptable than the great toe. One can also include the metatarsophalangeal joint and metatarsal without significant morbidity unlike the great toe. Studies have demonstrated excellent motor and sensory outcomes with the second toe transfer in both the adult and paediatric populations.