Sensate M-shaped digital artery flap for repairing fingertip defect caused by degloving injury in children

Abstract

Objective To investigate the clinical outcomes of M-shaped digital artery flap with nerve coaptation for treatment of fingertip degloving injury in children. Methods From March 2013 to March 2014, 9 pediatric cases of fingertip degloving injury were treated with M-shaped digital artery flap. The size of the flaps ranged from 3.0 cm×1.0 cm to 3.5 cm×1.2 cm. The dorsal cutaneous nerve inside the flap was coapted to the digital nerve on one side to restore sensation of the fingertip. Results All 9 flaps survived completely. The patients were follow-up for 6 to 14 months. The color, texture and contour of the flaps were good. Two-point discrimination was 6.0 to 9.0 mm on the flap. Joint movement of the fingers was normal. According to the upper limb functional assessment criteria issued by the Chinese Hand Surgery Society, the results were rated as excellent in 7 fingers and good in 2 fingers. No contracture complication occurred at the donor site. Conclusion The surgical procedure of M-shaped digital artery flap transfer is simple. The nerve coaptation makes it a sensate flap. It is an ideal method to treat fingertip degloving injuries. Key words: Finger injuries; Surgical flaps; Child