Exploring an 8-Hour Microsurgical Challenge at Beijing Jishuitan Hospital: Clinical Decision-Making and Technical Realization of Aesthetic Right Index Finger Reconstruction

🔬 In the field of microsurgery, simple functional reconstruction of finger defects already has a mature clinical system.

📊 However, facing aesthetic reconstruction with extremely high appearance demands, clinical techniques are challenged by sub-millimeter precision requirements.

🏥 Two years ago, Dr. Xue Yunhao's team at the Hand Surgery Department of Beijing Jishuitan Hospital treated a young female patient with a right index finger defect missing one and a half phalanges.

📷 As shown in the attached pre-operative photo, the patient's stump had healed at the initial visit, but the severe appearance defect caused significant social anxiety.

💡 After rigorous pre-operative evaluation, the team decided to abandon conventional stump revision and established a highly challenging aesthetic reconstruction plan.

🛠️ The final clinical procedure executed was an iliac bone graft combined with an autologous great toe nail flap composite tissue transfer.

📷 As indicated by the surgical markings on the foot in the attached photo, the harvesting of the donor flap required extremely high anatomical precision.

⏱️ During the 8-hour surgery, the team completed the anastomosis of ultrafine vessels and nerves under a high-definition microscope.

🧬 A unique nail fold reconstruction technique was integrated during the procedure to maximize the restoration of finger pulp fullness and skin crease details.

📷 The recent two-year post-operative follow-up images (see attached close-up photos) show that the reconstructed finger has excellent blood supply, and the skin creases and nail bed morphology closely resemble the contralateral healthy side.