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Objective To investigate the clinical effect of free second toe tibial flap in repairing fingertip skin and soft tissue defects. Methods From February 2016 to August 2019, 11 patients with fingertip skin and soft tissue defects were repaired with free second toe tibial flap at the Orthopaedic Trauma Center of PLA of The 988th Hospital of Joint Logistic Service of PLA. The area of soft tissue defect was 1.2 cm×2.0 cm to 2.0 cm×2.5 cm. The flap ranged from 1.3 cm×2.2 cm to 2.3 cm×2.8 cm. All donor site defects on the ipsilateral second toe were covered with full-thickness skin graft. There were 2 wounds in thumb, 4 in index finger, 4 in middle finger and 1 in ring finger. The wound defect area 1.2 cm×2.0 cm to 2.0 cm×2.5 cm. Skinflap cutting area 1.3 cm×2.2 cm to 2.3 cm×2.8 cm, the second toe on the same side of the donor site was selected and the full-thickness skin graft was transplanted. After the operation, the appearance, sensation and donor site recovery of the flap were regularly followed up by outpatient reexamination. Results All the flaps survived well in 11 cases and without any vascular crisis. Partial skin graft necrosis at the donor site was found in 1 case, and the wound healed gradually after daily dressing change. After 8 to 14 months of follow-up,the appearance and the texture of the recipient site flap was good, and no obvious dysfunction of the donor site was found. Thesensation of the 11 flaps was recovered to S2 to S3＋, and the two-point discrimination was 6 to 11 mm. The recovery of hand function was satisfactory. According to the trial criteria for evaluation of upper limb function of the Society of Hand Surgery of the Chinese Medical Association, 8 cases were excellent and 3 cases were good. The Vancouver Scar Scale was used to evaluate the fingertip scar. The scores of 11 cases in this group were 3 to 5, with an average score of 3.6. Conclusion The free second toe tibial flap is a rational therapeutic strategy for repairing the skin and soft tissue defect of fingertip. It has the advantages of constant bloodvessels, good sensory recovery, and concealed donor area. [ABSTRACT FROM AUTHOR]