A neurovascular island flap including a vein for the treatment of an acquired ring constriction

Abstract

We present a case of an acquired constriction band caused by a tight ring on the left middle finger of a 45-year-old man. Most of the constriction band was excised and the resulting defect reconstructed with a neurovascular island flap, including a dorsal digital vein, from the adjacent ring finger. The distal end of the artery and the nerve in the flap were anastomosed and coapted to the digital artery and nerve, respectively, at the distal edge of the defect after excision of the band. The vein in the flap was anastomosed to a dorsal vein at both the distal and proximal edges of the flap as a vascularised interpositional vein graft. Four months later, the remaining constriction band was excised and the defect closed by an advancement flap. Swelling of the finger decreased and sensation improved.