Application of V-Y advancement flap pedicled with dorsal cutaneous branch of digital artery with sensory nerve for repair of middle and distal dorsal finger defects

Abstract

Objective To investigate the surgical method and clinical efficacy of V-Y advancement flap pedicled with dorsal cutaneous branch of digital artery with sensory nerve for repair of middle and distal dorsal finger defects. Methods From September 2016 to August 2017, proximal or middle segment flaps with dorsal perforator branches of the proper digital artery were harvested. The flaps carried 1 to 2 dorsal digital nerves and/or dorsal branches of one dorsal digital proper nerve. The proximal end of the flaps was designed as V-Y shape. Eight patients with middle and distal dorsal finger defects were repaired by distal advancement. The area of dorsal finger skin defects ranged from 0.5 cm×1.3 cm to 2.0 cm×1.7 cm. All the patients underwent one-stage emergency operation, and the donor sites of the flaps were sutured directly. The area of the flaps ranged from 2.0 cm×1.8 cm to 4.5 cm×1.7 cm. Results All the wounds achieved primary healing and the flaps survived well. The period of follow-up ranged from 3 to 9 months with an average of 4 months. The interphalangeal joint activity was normal and the sensation of dorsal finger flap recovered to S3+. Conclusion The V-Y advancement flap pedicled with dorsal cutaneous branch of digital artery with sensory nerve can obtain satisfactory function and shape for repairing the skin defects of the dorsal middle and distal segments of finger with sensory recovery. The operation is simple and the donor site can be closed directly. It is a good method to repair the dorsal finger defects. Key words: Finger injuries; Surgical flaps; Dorsal branch of digital artery; Dorsal finger defects