Cross-Finger Flaps Outcome and Modification

Abstract

Background: Injuries to fingers are frequently encountered since these are the most exposed parts of the body and are in contact with devices and tools so are exposed to a multitude of risks. Various surgical methods such as skin grafting, stump closure, and microvascular reconstruction are in the armamentarium of the plastic surgeon. The cross-finger flap was described originally in 1950 and is one of the workhorse flaps for finger reconstruction and can be done as described originally or as a modification in multiple scenarios of finger trauma. Methods: This is a prospective single-centre multi-surgeon study carried out on 35 patients from 2018 to 2021 on patients undergoing cross-finger flap. All cross-finger flaps or any modification such as reverse cross-finger flap, or cross-finger flap on graft reposition were included. Each patient was analysed as per the aetiology, the treatment received, the reconstructive procedures done, the functional and aesthetic outcome, and any postoperative complications and their management. Results: The average follow-up of patients was two years. 22 out of 35 patients were male, and in 28 patients the injury had occurred in the right hand. The average age of patients was 34.5 years. Conclusion: Cross-finger flap is a simple and reliable flap among the various reconstructive options available for finger injuries. The modifications such as reverse cross-finger and graft reposition flap increase its application. The cosmetic outcome is usually satisfactory and the return of protective sensations is seen in most cases. At times it is a trade-off between extensive microvascular procedure and a marginally short finger with or without nails. Keywords: Cross-finger flap; Finger reconstruction; Graft reposition flap.