Finger tip Amputation Injuries. Restoration of Length & Sensibility Using Homodigital Neurovascular Island Flap

Abstract

Injury of the fingertip is the most common injury of the hand and fingertip amputation is the most common amputation in the upper extremity. The pulp of the fingertip is that part of the finger with the richest vasculature and the highest density of nerve ends. A normal digital pulp is vital to the interaction between the brain and the upper extremity required in the finest daily activities. The contribution of the digital pulp to key pinch and tip pinch depends mainly on its neurovascular integrity. Pulp support by the nail is also needed for tip pinch and key pinch. This report analyses 81 consecutive cases (77 patients - 81 digits) of homodigital neurovascular island flaps operated on by one surgeon between 2002 and 2014. The surgical technique, indications, contra-indications and three year results are evaluated. Overall, these flaps provide reliable vascularity as well as normal sensibility at the distal end of the finger where high quality perception is required.