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Diagnostic IV. Diagnostic IV. To evaluate the risk factors for, and clinical outcomes of, free lateral great toe flaps for the reconstruction of thumb pulp defects. Between January 2009 and July 2017, 31 patients with thumb pulp defects were treated with free lateral great toe flaps. Seven patients were lost to follow-up. We included 9 female and 15 male patients, average age 35 years. We performed a retrospective review of risk factors, clinical outcomes, and complications. For patients in which the flap survived, we assessed postoperati