Comparative study of the effect of innervated reverse digital artery island flap and the digital artery island flap with dorsal branches for fingertip repair

Abstract

Objective To compare the clinical effect of innervated reverse digital artery island flap and the digital artery island flap with dorsal branches in the repair of fingertip defects. Methods From January 2014 to June 2015, a total of 43 cases (50 fingers) with fingertip defects in 2-5 fingers were randomly treated with reverse digital artery island flaps (23 cases) or the digital artery island flaps with dorsal branches (20 cases). All cases underwent emergency surgery. The operative time, patient satisfaction of appearance for the reconstructed fingers, the static 2-point discrimination of the flaps, active motion of the injured finger joints and postoperative appearance on donor site were compared respectively. Results All flaps survived primarily. The follow-up period ranged from 12-18 months. No significant differences were found in operative time and active motion of the injured finger joints between the two groups (P>0.05). Patient satisfaction of appearance and the static 2-point discrimination of the flaps in reverse digital artery island flap group were better than those in the digital artery dorsal branch island flap group (P<0.05). For the donor site, the texture of donor site in reverse digital artery island flap was soft without significant Scar contracture and pigmentation. There were 5 cases with mild scar contracture in donor site at the digital artery island flap with dorsal branches. Conclusions The reverse digital artery island flap and the digital artery island flap with dorsal branches are all suitable for the repair of fingertip defects. Compared with the digital artery island flap with dorsal branch, the reverse digital artery island flap can provide better fingertip sense and appearance. Key words: Fingers; Defect; Skin flap; Comparative study