The dorsal approach in harvesting the second toe.

The dorsal approach, with early section of the second metatarsal bone, allows direct access to the plantar structures of the second toe (arteries, nerves, and flexor tendons). A "multiple set arterial transfer" then becomes possible, improving the blood supply to the toe. Early walking is encouraged on the fifth postoperative day when the patient leaves the hospital. No vascular complications have occurred in any microvascular reconstruction after the fifth postoperative day. Close approximation of the first and third toe of the donor foot not only improves the overall appearance of the foot, but also avoids a possible hallux valgus deformity as a postoperative complication.