Homodigital metacarpophalangeal dorsal transverse flap based on the dorsal branch of the proper palmar digital artery for resurfacing fingertip defects of the thumb

Abstract

Objective To investigate the surgical methods and clinical results of repairing skin defect of the thumb with the homodigital metacarpophalangeal dorsal transverse flap based on the dorsal branch of the proper palmar digital artery. Methods From November, 2013 to May, 2015, 17 cases skin defects of the thumb were treated with the homodigital metacarpophalangeal dorsal transverse flap based on the dorsal branch of the digital artery close to the defect. Of the 17 patients, 11 were males and 6 were females. Their ages ranged from 18 to 46 years, with average of 31.3 years. The digital nerve of 13 patients was attached with the flap to restore neurosensory function. The size of fingertip losses ranged from 1.5 cm × 2.0 cm to 2.0 cm × 2.5 cm. The size of the flaps ranged from 1.8 cm × 2.0 cm to 2.0 cm × 2.8 cm. Results The homodigital metacarpophalangeal dorsal transverse flap based on the dorsal branch of the digital artery survived uneventfully during the follow-up period between 5 to 15 months. All the patients were contented with the aesthetic and functional outcomes of the flaps. The 2-point discrimination of the flaps was 6 mm to 10 mm. Conclusion The homodigital metacarpophalangeal dorsal transverse flap based on the dorsal branch of the digital artery is reliable alternative to reconstruct fingertip defects of the thumb at the primary stage.The main advantages of the flap include the simplicity of its procedure; the reliable blood supply and return of sensation. Key words: Thumb; Proper digital artery; Perforator flap; Metacarpophalangeal joint; Repair