Finger Reconstruction after Electrical Burn Injury Using a Vascularized Second Toe Digital Nerve Graft: A Case Report

Digital nerve injury of the finger often results in sensory impairment, particularly when accompanied by concomitant digital artery injury, because both structures lie in close proximity. Post-traumatic fibrosis and compromised local circulation may create a poorly vascularized recipient bed, resulting in a suboptimal environment for conventional non-vascularized nerve grafting. This report describes the use of a vascularized second toe digital nerve graft for finger sensory reconstruction in this setting. A 26-year-old man presented with persistent sensory impairment of the middle finger following an electrical burn injury. Though split-thickness skin grafting had been performed at another institution, sensory recovery remained unsatisfactory. The patient complained of sensory dullness on the radial side of the fingertip with occasional tingling sensations. Intraoperative exploration revealed fibrotic degeneration of the digital nerve and accompanying digital artery, resulting in an approximately 2.3-cm nerve gap after debridement. Reconstruction was performed using a vascularized second toe digital nerve graft. Gradual sensory recovery was achieved, with a final two-point discrimination of 6 mm and minimal donor-site morbidity, demonstrating that vascularized second toe digital nerve grafting may be an effective reconstructive option for finger injuries associated with combined digital neurovascular bundle damage and compromised local vascularity.