Reconstruction of the foot’s distal portion has always been a difficult problem in plastic surgery. Moreover, isolated soft tissue defects of the hallux are not common in daily practice. In the case of tissue loss over the hallux, it is common practice to treat the soft tissue defect conservatively or to apply a skin graft. But the loss of tissue leaves a shortened, hypersensitive, and deformed toe. A method for reconstruction of a soft tissue defect on the tip of the hallux by means of a pedicled heterodigital artery flap from the second toe is presented, and alternative flap choices for this challenging area of the distal foot are discussed. To the best of the authors’ knowledge, this surgical approach for reconstruction of hallux tip defects has not been reported previously.

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