Transfer of a radial digital artery reverse island flap from proximal phalange of the middle finger to cover fingertip defect of the thumb

Abstract

Objective To present the application of a radial digital artery reverse island flap from proximal phalange of the middle finger for repair of fingertip defect of the thumb.Methods Ten cases of fingertip defect of the thumb were treated with this flap that was based on radial digital artery at the proximal phalangeal level of the middle finger.The pedicled flap was transferred to the defect site.The donor site was directly closed.To restore sen.~tion of the flap,the dorsal branch of the proper digital nerve was inclnded in the flap and sutured to the proper digital nerve in the severed thumb stump.Results All the flaps survived completely.Incisions were healed by first intention.The patients were follow-up for 3 to 12 months.The thumbs had good appearance after the reconstruction.The flaps were supple and resistant to wear and tear.There was no touch pain.The two-point discrimination was 4 to 6 mm.There was no complication at the donor site and no limitation in the movement of the interphalangeal joint.According to the functional evaluation criteria of the upper limb issued by the Hand Surgery Society of the Chinese Medical Association,active range of motion was rated as excellent in 9 cases and good in 1 case.Conclusion Transfer of the radial digital artery reverse island flap from proximal phalange of the middle finger to cover defects of the thumb tip can lead to good appearance and sensation.It is a simple and reliable operative method. Key words: Island flaps; Surgical procedures, operative; Cross-finger flaps; Thumb fingertip defect