Distally based neurovascular fasciocutaneous island flap of the proper digital nerve dorsal branch to repair fingertip defects

Abstract

Objective To analyze the clinical outcomes of treating fingertip defects with distally based neurovascular fasciocutaneous island flap of the proper digital nerve dorsal branch.Methods Twenty-three cases with soft tissue defects in the pulp or dorsum of the fingertip were treated by the distally based neurovascular fasciocutaneous island flap of the proper digital nerve dorsal branch from July 2010 to January 2012.Results All 23 flaps survived completely.Twenty-one cases were follow-up from 3 to 15 months with an average of 6.7 months postoperatively,while 2 cases were lost.One flap for repair of the middle finger pulp shrank postoperatively and the bone was exposed.Stump revision was done.The other 20 flaps were with proper thickness,supple texture and good color.There was no donor site tendon adhesion or scar retraction that impairs joint movement.According to the criteria for functional assessment of the upper extremity issued by the Chinese Hand Surgery Society,the overall good-excellent rate was 87％.Conclusion Distally based neurovascular fasciocutaneous island flap of the proper digital nerve dorsal branch is a satisfactory method for treatment of fingertip defects. Key words: Finger injuries; Surgical flaps; Treatment outcome; Proper digital nerves