With the development of microsurgical techniques, the toe graft method of finger reconstruction has become more and more widely used, which has brought blessings to many patients with finger defects, allowing them to regain a functional finger. As this surgical method has spread, in the pursuit of continuous improvement, more and more scholars have noticed that there are still many problems with toe graft reconstructed fingers. One of the main problems is the appearance defect of the reconstructed finger with an enlarged terminal segment and a narrow middle segment. Some young patients, in particular, have higher requirements for the appearance of the reconstructed finger. For this reason, we designed a safe and simple local transfer flap surgery according to the shape characteristics of the reconstructed finger of the toe graft, to trim the shape of the reconstructed finger and obtain good results. The flap is designed with a lingual flap in the abdomen of the terminal phalanx, with the tip located from the distal interphalangeal joint to the lateral side of the middle phalanx, and the flap is oblique to the distal side of the terminal phalanx, with a width of 8 to 12 mm and a length of 15 to 20 mm, with a length to width ratio of 1.5:1 to 2:1. The other incision starts at the proximal 1/3 of the flap, and is oblique to the proximal side of the transverse phalanx on the palmar side of the middle phalanx. 2, flap separation: incision deep and flexor tendon sheath superficial layer, pay attention to the flap together with the fascial tissue lifted. During the flap separation process, attention was paid to protecting the bilateral finger neurovascular bundles to avoid injury. A total of two flaps were formed, a tongue-shaped flap located on the ventral part of the terminal finger and a triangular flap on the palmar side of the middle finger. 3. Flap transfer: turn the lingual flap of the end phalanx to the middle phalanx of the reconstructed finger to thicken the middle phalanx, push the triangular flap of the middle phalanx to the distal end, and close the trauma after flap transfer. Second, postoperative follow-up early after surgery to observe the blood circulation and infection of the flap. Evaluation of the improvement of finger appearance was performed at the final follow-up. The indexes used included the ratio of the circumference of the middle and end segments of the reconstructed finger and the ratio of the length of the finger belly; the joint mobility of the reconstructed finger before and after surgery and the discrimination of two points of movement; and the subjective satisfaction evaluation. Results All patients were followed up for 6 to 12 months (mean 9.3 months). All flaps in this group were viable, with normal color, no arteriovenous circulation was affected, and the incision healed well, and the stitches were removed in 12-15 days. 2.The appearance of the reconstructed finger improved significantly after surgery. The enlargement of the terminal phalanges disappeared, the middle phalanges were thickened, and the middle and terminal phalanges were more uniform. Before and after surgery, the length ratio of the end joint to the middle joint changed from 2:1 to nearly 1:1. The circumference and width of the end joint were significantly larger than that of the middle joint before surgery, but the middle and end joints were similar after surgery. The incisional scar formed after flap transfer was located similarly to the distal and proximal transverse finger lines. In the early postoperative period, due to the pulling of the skin by the flap transfer, the skin of the finger belly was mildly distorted, and the distortion gradually diminished and disappeared after 1~2 months with the extension of time and the use of the reconstructed finger. 3. Functional changes of the reconstructed finger: there was no significant change in the sense of moving two points of discrimination before and after the surgery, about 4~6 mm. the incision scar was oblique and close to the direction of the skin pattern, which did not affect the activities of the finger joints, and there was no significant difference in finger mobility before and after the surgery. 4.Subjective satisfaction The patients were satisfied with the improvement of the appearance of the reconstructed fingers before and after surgery in 11 fingers, and those who felt average in 3 fingers. The overall subjective satisfaction of the patients was good. A typical case is a male, 19 years old, who was damaged by a meat grinder in the right hand middle ring little finger, and underwent emergency debridement surgery to preserve the maximum length of the finger, with the defect plane in the proximal 1/3. 5 days after the injury, the right middle and ring fingers were reconstructed by transplanting the second and third toes of the right foot, and the right index finger was reconstructed by transplanting the second toe of the left foot 20 days after the injury. All of the reconstructed fingers were viable, but the reconstructed fingers had obvious cosmetic defects. Seven months after the reconstructive surgery, finger ventral revision and middle ring finger split finger implantation were performed. The appearance of the reconstructed finger improved significantly after surgery. The free toe (2nd toe) transplantation for bunion reconstruction pioneered by Yang Dongyue et al. is considered to be the most ideal method for bunion reconstruction at present. With the development of microsurgery technology, free second toe grafting has become a routine procedure in hand surgery. Finger reconstruction has given many patients with finger defects more hand function and confidence in life and work. However, the downside is that the shape of the reconstructed finger is still not as good as it should be. The appearance of the second toe is significantly different from that of the finger because of the enlarged end phalanx and the small middle phalanx, making the appearance one of the most important factors in the operation. The anatomical differences between the appearance of the toe and the finger were compared by measuring the appearance of the finger and toe in 30 normal people. It was seen that there were significant differences in the appearance of the toes and fingers. The fingers were tapered, with the width and circumference of the distal, middle, and proximal segments increasing in sequence; the toes were pestle-shaped, with the distal end thickening and the proximal and middle segments thinning. The length ratio between the end and middle joints of the fingers is close to 1:1, while the length ratio between the end and middle joints of the toes is greater than 2:1. The subcutaneous fat is evenly distributed in the finger bellies of the fingers; the subcutaneous fat of the end joints of the toes is full and abundant, while the amount of subcutaneous tissue in the middle joints is small and the skin is thin, which makes the hunchback deformity of the toes more obvious. The method presented has the following advantages: 1. simple method, easy to perform surgical design, and easy to promote application. 2. satisfies the purpose of both end- and mid-segment revision. 3. local transfer of the flap, which does not require important blood vessels for the tip, is safe and has no effect on the normal function of the finger. 4. the skin of the end- and mid-segment finger belly formed after flap revision is of good texture and uniform subcutaneous tissue. The skin suture after flap transfer forms a depression approximating the distal and proximal finger transverse lines, with a ratio close to 1:1, which does not affect the flexion and extension activities of the fingers. 5, when the second and third toes are jointly transplanted to reconstruct two fingers, the finger belly revision surgery can be performed simultaneously with the split finger implant surgery, which has been proven to be safe and feasible. 6, before and after the reconstructive surgery, there is no effect on the sensory blood supply of the reconstructed fingers. The timing of surgery: the case in the reconstructive surgery after 4 to 10 months to perform the finger ventral revision surgery. Considering the reconstruction of blood supply, bone healing, functional exercise of the finger, recovery of sensory movement, softening of scar tissue, safety of finger splitting surgery and other factors after reconstructive surgery, we think it is appropriate to operate after 4~6 months. Regarding whether to perform the revision of the finger belly at the same time as the reconstructive surgery, although it may be theoretically safe, excessive separation and treatment of the distal finger in the first stage may increase the risk of necrosis and dysfunction of the reconstructed finger. Clinical practice has demonstrated that this local transfer flap for finger ventral revision is simple, safe, and has no effect on finger function and is suitable for promotion. However, it is important to emphasize that any plastic treatment cannot make the reconstructed finger achieve the exact same shape as the normal finger, and the function of the reconstructed finger is still the first priority.