Proximal dorsal digital artery pedicled island flaps for reconstruction of adjacent finger soft-tissue defect

Abstract

Objective To assay the clinical effect of proximal dorsal digital artery pedicled island flap in treatment and sensory reconstruction of adjacent finger soft-tissue defect. Methods The study enrolled 21 cases of soft-tissue defect in 21 fingers treated from January 2013 to January 2014. All the defects were covered with the proximal dorsal artery pedicled island flaps raised from the adjacent finger. Index finger was injured in 7 patients, middle finger in 9 patients, ring finger in 4 patients, and little finger in 4 patients. Defect and flap dimensions varied from 1.9 cm × 1.5 cm to 4.3 cm× 2.3 cm and from 2.0 cm×1.7 cm to 4.5 cm × 2.5 cm respectively. Donor site was resurfaced with a full-thickness skin harvested from medial side of the upper arm. Postoperative flap appearance and two-point discrimination were evaluated. Total active motion (TAM) of the finger was evaluated after operation. Results All the flaps and skin grafts survived after operation. Duration of the follow-up was 6-18 months (mean, 14.7 months). Through the final follow-up, appearance and function of the flap were satisfactory, donor site healed well, and two-point discrimination was 5-9 mm (mean, 6.3 mm). TAM evaluation was excellent in 19 patients and good in 2 patients with the excellent-good rate of 100%. Conclusion The proximal dorsal artery pedicled island flap raised from the adjacent finger is an ideal choice in finger soft-tissue reconstruction, for the technique has advantages of high survival rate, satisfactory appearance and sensory function as well as few complications. Key words: Fingers; Soft tissue injuries; Surgical flaps; Microsurgery