Reconstruction of palmar finger soft tissue defects by using first dorsal metatarsal artery Flow-through flap with digital artery and nerve anastomosis

Abstract

Objective To investigate the treatment of outcomes of repairing soft tissue defects of the palmar finger accompanied by proper digital artery and nerve defects. Methods From January, 2014 to June, 2016, 7 patients (4 males and 3 females. Patients′ age ranged from 18 to 45 years, with an average of 28.5 years) with soft tissue defects on the palmar side of the proximal and middle phalanx of the fingers accompanied by proper digital artery and nerve defects were treated by first dorsal metatarsal artery Flow-through flap, application of color Doppler ultrasound was used in the detection of vascular type before operation. The flap area was from 2.0 cm×2.5 cm to 3.5 cm×5.5 cm. All the donor site of the flap were sutured directly. The patients were followed-up in 1 month, 3 months, 6 months, 12 months, 24 months after the surgery, and the results were evaluated according to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association. Results All flaps survived. These cases were followed-up for 6 to 24 months, average 12 months. All the flaps got satisfactory appearance and good sense function, and 2-PD of the flap averaged 7 mm, ranging from 6 mm to 12 mm. All injured fingers got satisfactory appearance and good sense function, 2-PD of the injured fingers averaged 8 mm, ranging from 6 to 15 mm. The donor site incision healed well, no obvious scar hyperplasia, good function. Conclusion Application of the first dorsal metatarsal artery Flow-through flap to reconstruct soft tissue defects of the palmar finger accompanied by proper digital artery and nerve defects, can achieve good clinical effects. This method can restore the appearance, blood supply and sensation of the injured finger. Key words: Finger injuries; Proper palmar digital arteries; Flow-through flaps; First dorsal metatarsal artery