Reconstruction of finger-pulp defect with a homodigital laterodorsal fasciocutaneous flap distally based on the dorsal branches of the proper palmar digital artery

Abstract

Objective The purpose of our study was to introduce the surgical procedure and long-term follow-up of finger-pulp defect treated with the homodigital laterodorsal fasciocutaneous flap, which is based on the dorsal branches of the proper palmar digital artery. Methods Seven cases with finger-pulp defect, which were treated by the homodigital laterodorsal fasciocutaneous flap based on the dorsal branches of the proper palmar digital artery, were involved in this study. The defect size ranged from 14.5 mm × 14.5 mm to 24.5 mm × 16.5 mm. Average duration of follow-up was 12 months (range, 10–36 months). Standardised assessment of outcome in terms of the defect size of finger-pulp, survival size of the flap, the static and moving two-point discrimination, time of returning to work and subjective assessment (satisfactory, good and very good) was completed. Results All flaps in this series survived uneventfully. No loss of the flap in this series was noted. The average size of the flaps was 18.43 mm × 15.28 mm. The flaps had a good appearance, texture and blood circulation. The average static two-point discrimination and moving two-point discrimination of the flaps were 4.5 mm (range, 4–6 mm) and 4.3 mm (range, 3–6 mm). All patients were content with the aesthetic and functional outcome of the surgery, and returned to their original job after an average of 4 weeks (range, 3–8 weeks) postoperatively. Conclusion The homodigital laterodorsal fasciocutaneous flap based on the dorsal branch of the proper palmar digital artery is an ideal alternative to reconstruct the finger-pulp for single-stage reconstruction without sacrificing the proper palmar digital artery and nerve.