Reconstruction of the Fingertip Defect with a Free Radial Artery Superficial Palmar Branch Flap and Iliac Bone Graft

Junsang Lee; Hyun Sik Park; Jong Ick Whang

doi:10.12790/ahm.2019.24.4.376

Journal List > Arch Hand Microsurg > v.24(4) > 1138588

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Lee, Park, and Whang: Reconstruction of the Fingertip Defect with a Free Radial Artery Superficial Palmar Branch Flap and Iliac Bone Graft

Case Report

Archives of Hand and Microsurgery 2019; 24(4): 376-380.

Published online: 29 November 2019

DOI: https://doi.org/10.12790/ahm.2019.24.4.376

Reconstruction of the Fingertip Defect with a Free Radial Artery Superficial Palmar Branch Flap and Iliac Bone Graft

Junsang Lee¹

, Hyun Sik Park², Jong Ick Whang¹

¹Department of Plastic and Reconstructive Surgery, Institute of Hand and Microsurgery, Duson Hospital, Ansan, Korea.

²Department of Orthopedic Surgery, Institute of Hand and Microsurgery, Duson Hospital, Ansan, Korea.

Corresponding author: Junsang Lee. Department of Plastic and Reconstructive Surgery, Institute of Hand and Microsurgery, Duson Hospital, 114 Seonbugwangjang 1-ro, Danwongu, Ansan 15368, Korea. TEL: +82-31-402-0114, FAX: +82-31-414-1903, junsang9180@gmail.com

Received 21 August 2019 Revised 17 September 2019 Accepted 19 September 2019

Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fingertip injury occurs due to various causes. Trauma is the most common cause, and most cases are accompanied by bone defects as well as skin and soft tissue defects. When soft tissue and bone defects occur at the fingertip, it is necessary not only to cover the soft tissue defects but also to reconstruct the bones to ensure stability of the fingertip. The authors performed a free radial artery superficial palmar branch flap and iliac bone grafts in patients with soft tissue and bone defects at the fingertip, with satisfactory results. A literature review was also conducted.

Keywords: Free flap, Graft, Injury

Figures and Tables

Fig. 1

A 54-year-old male with skin, soft tissue and bone defects on the left 2nd finger caused by a crushing injury. (A, B) Preoperative photo. (C) Preoperative X-ray. Most of the distal phalangeal bone of the left 2nd finger was lost (informed consent was taken).

Fig. 2

The day after the first operation, a free radial artery superficial palmar branch flap was performed. (A) Flap elevation. (B) Flap insetting.

Fig. 3

One month after flap surgery. (A, B) The skin and soft tissue defects were covered with a free radial artery superficial palmar branch flap. (C) Temporary fixation with K-wire.

Fig. 4

Six weeks after flap surgery, an autogenous iliac bone graft was done.

Fig. 5

Eight months after free radial artery superficial palmar branch flap coverage. (A, B) Postoperative photo. There were no functional problems such as scar contracture or skin atrophy. (C) Six months after the autogenous iliac bone graft, a bone union was done.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

References

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8. Thanik V, Shah A, Chiu D. A technique for tripartite reconstruction of fingertip injuries using the thenar flap with bone and nail bed grafts. J Hand Surg Am. 2017; 42:1040.e1–1040.e7.

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ORCID iDs: Junsang Lee
https://orcid.org/0000-0001-6557-3027
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