Clinical application of dorsal proximal phalangeal flap for covering donor site defect of reverse digital

Abstract

Objective To introduce the surgical techniques of repairing donor site defect of reverse digital artery island flap by perforator flap from the dorsum of the proximal phaalanx. Methods Fifteen cases with skin defects of the fingertips were treated with reverse digital artery island flap transfer.Defects at the donor site were repaired with perforator flap from the dorsum of the proximal phalanx. Results All 30 flaps survived in 15 cases.The patients were follow-up for 5 months to 2 years.The appearance and the texture of the flaps were good.The fingers were pain free.Two-point discrimination was 7 to 8 mm for the island flaps and 8 to 10 mm for the perforator flaps.According to the hand function evaluation criteria issued by the Chinese Hand Society,the hand function was graded as excellent in 13 cases and good in 2 cases.There were no obvious complications of the donor sites.The width and depth of the web space were not affected.There was no web contracture and finger abduction reached 30° to 40°, close to normal. Conclusion This procedure is easy and effective.The treatment result is satisfactory.It is an improvement over conventional donor site defect repairing techniques in reverse digital artery island flap transfer. Key words: Finger injuries; Surgical flaps; Tissue defect