A segmental finger defect was reconstructed in a 46-year-old woman with a free flow-through vascularized toe-joint, including the proximal interphalangeal joint, the plantar digital nerve, and tendons of the second toe. The advantages of this composite flap are: (1) The segmental loss of the finger can be easily reconstructed to achieve a normal anatomic structure. (2) Excellent cosmesis is achieved, compared with conventional flaps such as the groin flap. (3) The distal segment of the donor toe can be preserved. (4) The transected digital arteries of the amputated finger can be simultaneously reconstructed with a flow-through arterial interposition. (5) The digital nerve can be repaired with a vascularized plantar digital nerve graft.