Abstract
A 23-year-old male student presented to our clinic with a traumatic complex ring avulsion of his right dominant index finger. Clinical evaluation revealed a complete distal amputation of the DIP joint with a laceration of the soft tissue at the middle phalanx and a rupture of the FDP-2-tendon far proximally. We hereby present the patient’s clinical outcome after reconstruction with a distally based extended DMCA-II flap. To our own knowledge, this is the first report of an extended distally based DMCA flap for coverage of a class IVd ring avulsion injury in combination with autologous amputate skin transplantation.Level of Evidence: Level V, therapeutic study.
Highlights
Ring avulsion injuries are difficult to treat despite more and more upcoming indications for microsurgical replantations
The distally based DMCA flap and its modifications have a broad spectrum of indications
The flap has not gained its position in amputation and deglovement injuries
Summary
Ring avulsion injuries are difficult to treat despite more and more upcoming indications for microsurgical replantations. When amputates are either missing or in poor condition there are usually two options: First, further amputation or ray resection or second, free transplantation. In cases in which the patient isn’t suitable for both, the options are limited. The distally based DMCA flap and its modifications have a broad spectrum of indications. To our knowledge, this is the first described case of a DMCA wraparound modification for finger amputations. This is the first described case of a DMCA wraparound modification for finger amputations In selected cases, this procedure may be a helpful additional reconstructive option
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