Abstract
Purpose:
The reverse digital island flap is useful for the repair of various fingertip injuries. We present a modified surgical technique with skin strip elevation for the prevention of postoperative congestion.
Methods:
From January 2005 to October 2015, we performed 31 reconstructive procedures for finger injury using a reverse digital artery island flap with and without skin strip retention. Patients’ clinical characteristics, surgical outcomes, and complications were investigated.
Results:
All flaps survived and there were no donor site problems. The mean follow-up time was 5 months (range, 3-8 months). In skin strip retention group, mild venous congestion was observed in 1 case, although it resolved spontaneously. Another case retained flexion contracture, and 2 patients had stiffness at the distal interphalangeal joint. Whereas, in no retention group, venous congestion was observed in 3 cases, 1 patient had partial flap necrosis and 2 patient suffer in flexion contracture at metacarpophalangeal joint.
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Fig. 1.
A 61-year-old-male with posttraumatic amputation, the defect size was about 1.5×2.0 cm over the left thumb. (A) Reverse-flow heterodigital island flap with skin strip was elevated from index finger. (B) The flap with skin strip was transferred into the defect. (C) Five months after the operation, the flap circulation was intact.
![jkssh-21-70f1.tif](/upload/SynapseXML/0149jkssh/thumb/jkssh-21-70f1.gif)
Table 1.
Patient data of the reverse digital island flap without skin strip retention
Case | Age (yr) | Sex | Cause | Lesion | Detach (day) | |
---|---|---|---|---|---|---|
1 | 45 | Male | Grinder | Rt | Ring | * |
2 | 40 | Male | Milling machine | Rt | Little | * |
3 | 48 | Female | Press | Rt | Ring | * |
4 | 28 | Male | Grinder | Rt | Index | 7 |
5 | 10 | Female | Knife | Rt | Thumb | 12 |
6 | 48 | Male | Grinder | Lt | Middle | * |
7 | 47 | Male | Grinder | Lt | Ring | 15 |
8 | 25 | Male | Milling machine | Lt | Ring | 15 |
9 | 37 | Female | Milling machine | Lt | Index | * |
10 | 50 | Male | Press | Rt | Middle | * |
11 | 36 | Male | Milling machine | Rt | Little | * |
Table 2.
Patient data of postoperative complications without skin strip retention
Table 3.
Patient data of the reverse digital island flap with skin strip retention
Case | Age (yr) | Sex | Cause | Lesion | Detach (day) | |
---|---|---|---|---|---|---|
1 | 71 | Male | Rope | Rt | Middle | 14 |
2 | 57 | Female | Press | Lt | Ring | * |
3 | 61 | Male | Press | Lt | Thumb | 8 |
4 | 44 | Male | Grinder | Rt | Thumb | 11 |
5 | 77 | Female | Snake bite | Rt | Ring | 11 |
6 | 38 | Male | Press | Rt | Middle | * |
7 | 54 | Male | Milling machine | Rt | Thumb | 14 |
8 | 35 | Male | Traffic accident | Rt | Thumb | 10 |
9 | 84 | Female | Snake bite | Rt | Index | 13 |
10 | 36 | Male | Press | Lt | Ring | 11 |
11 | 57 | Female | Knife | Lt | Thumb | 12 |
12 | 67 | Male | Snake bite | Lt | Index | * |
13 | 48 | Female | Milling machine | Rt | Thumb & index | 10 |
14 | 34 | Male | Rope | Lt | Ring | 14 |
15 | 37 | Female | Press | Lt | Middle | * |
16 | 40 | Male | Milling machine | Rt | Little | 13 |
17 | 32 | Male | Milling machine | Lt | Little | 12 |
18 | 57 | Male | Snake bite | Rt | Index | 12 |
19 | 29 | Male | Milling machine | Lt | Ring | 13 |
20 | 19 | Male | Press | Lt | Index | 10 |
Table 4.
Patient data of postoperative complications with skin strip retention