指根部远近端蒂岛状皮瓣修复相邻两指指端缺损

Objective To introduce a new surgical procedure for repairing fingertip defects of two neighboring fingertips.Methods Seven cases of fingertip defects of two neighboring fingers were treated by transferring a proximal and a distal island flap harvested from the base of one of the involved fingers.The distal flap was transferred to repair defect of the same finger,while the proximal one was transferred to repair defect of the neighboring finger.There were defects of the index and middle fingers in 2 cases,defects of the middle and ring fingers in 4 cases,and defects of the ring and little fingers in 1 case.Finger pulp defect occurredins 8 digits,soft tissue defect distal to middle phalanx in 4 digits,and defect of ringer stump in 2 cases.Exoosure of the tendon,nerve or bone was seen in all cases.The size of the proximal flaps ranged from 1.2cm× 1.5 cm to 2.3 cm×1.5cm,while the size of distal flaps ranged from 1.0cm×1.0 cm to 1.5cm×1.0cm. Results All 14 flaps in the 7 cases survived completdy.One patient underwent secondary correction of crooked nail 6months after the fkap surgery.Postoperative follow-up rangea from 6 months to 18 months.All repaired fingers had satisfactory appearance and texture.Two-point discrimination was 8 to 12 mm.The good and excellent rate of finger function recovery was 95.7%according to the provisional functional assessment criterion for upper limbs issued by the Chinese Hand Surgery Society. Condusion The flap design of this procedure is based on the anatomical characteristics of communicating branches of the digital artery at the base of the finger.Two flaps from the base of the same finger are harvested to make full use of the harvestable area of the donor finger,and avoid damage to another finger.This procedure expands the applicable indications of finger base island flaps and is an ideal method to repair defects of neighboring fingers.

Repair of fingertip defects of two neighboring fingers with proximal and distal pedicled island flap from finger base