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Objective: To investigate surgical methods and clinical efficacy of free microflaps from the big and second toe for repair of palmar soft tissue defects of the fingers. Methods: During the period from August 2007 to July 2010, 31 patients with palmar soft tissue defects of the fingers were treated with free microflaps from the big or second toe. The soft tissue defects were on the thumb in 15 patients, the index finger in 7 patients, the middle finger in 6 patients, and the proximal part of the index and ring fingers accompanied by artery defects in 3 patients. In 28 patients, pulp defects were present. A big toe fibular flap was used in 15 patients, a second toe tibial flap in 13 patients, and a second toe C-shaped flap in 3 patients. The average flap size was 2.0 × 2.5 cm (range, 1.5 × 1.5 cm - 3.0 × 3.5 cm). Patients were followed for 6-12 months. Results: All flaps survived with good blood supply, texture, and elasticity. The pulp was full and the appearance was satisfactory. The two-point discrimination threshold was 6-9 mm. Wound healing of the donor site of the toes was grade I, without any impact on shoe-wearing and walking. Conclusions: Big toe and second toe free microflap transplantation is ideal for repair of finger pulp defects or a small palmar soft tissue defects combined with a neurovascular bundle defect of the finger.