Repair soft tissue defect of middle-and-distal finger with reversed flap based on cutaneous branch of dorsal metacarpal artery

Abstract

Objective To observe the treatment outcome of using reversed island flap based on cutaneous branch of dorsal metacarpal artery for middle-and-distal finger soft tissue defect. Methods From May, 2015 to March, 2017, 21 cases of middle-and-distal finger soft tissue defect were treated with reversed island flaps based on cutaneous branch of dorsal metacarpal artery which were designed on the dorsal hand pedicled by dorsal metacarpal artery. The flap was then elevated and rotated at the point where digital common artery was anastomosed with the terminal branch of the dorsal metacarpal artery. The cutaneous nerve included in the flap was anastomosed with the terminal branch of digital nerve to restore sensation and the donor site was covered directly. Regular followed-up was performed after operation. Results Except 1 case was suffered with distal 1/3 skin flap necrosis, flaps were well developed. Postoperative follow-up period was 3 to 12 months. All these flaps recovered with satisfying appearance and quality, excellent sensation with grade S3 to S4 and 5 to 8 mm of two-point discrimination. Range of motion(ROM) of the metacarpalphangeal and interphalangeal joint of the injured fingers was good. The excellent and good rate was 95.2%. Conclusion Reversed island flap based on dorsal cutaneous branch of dorsal metacarpal artery transfer is an ideal method for repairing middle-and-distal finger soft tissue defect. The surgery is simple. Reliable blood supply and sensation can be achieved without sacrificing the primary artery and nerve. There is minor donor site damage and very few complications. Key words: Dorsal metacarpal artery; Surgical flap; Finger injury; Microsurgical operation