Mini perforator propeller flaps for coverage of soft tissue defects of the finger

Abstract

Objective To discuss the surgical technique and clinical outcomes of digital artery perforator mini propeller flap for soft tissue coverage of finger defects. Methods Soft tissue defects of the fingers in 18 patients were repaired with digital artery perforator mini propeller flap from December 2013 to December 2014. The defects involved the thumb in 8 cases, the index finger in 5 cases, the middle finger in 3 cases, and the ring finger in 2 cases. The size of the defect ranged from 1.5 cm×0.9 cm to 3.5 cm×2.0 cm. Tendon or bone exposure existed in all the cases.The flap size ranged from 2.5 cm×1.1 cm to 5.0 cm×2.5 cm. The donor sites could be closed directly in 8 cases while skin graft was required in 10 cases. Results Flaps in 15 cases survived uneventfully, while those in 3 cases had venous crisis which was resolved by removing some of the stitches. All but 2 patients had 3 to 12 months postoperative follow-up, with an average of 8 months. The flaps had satisfactory appearance and pliable texture. According to the upper limb functional assessment criteria formulated by the Hand Surgery Society of the Chinese Medical Association, the results were excellent in 8 cases, good in 6 cases, and fair in 2 cases. Conclusion Digital artery perforator mini propeller flap is a good option for soft tissue coverage of finger defects. The procedure is relatively simple with less damage to the donor site. Aesthetic and functional outcomes are satisfactory. Key words: Hand injuries; Microsurgery; Propeller flaps; Digital artery