[Use of distally based intermetacarpal flaps to cover dorsal traumatic defects of the middle fingers].
BACKGROUND
The presence of distal intermetacarpal anastomoses between dorsal and palmar vascular networks makes it possible to dissect and isolate Distally Based Dorsal Hand (DBDH) flaps. Quaba and Davidson first described this possibility. The purpose of this paper is to report our experience using the DBDH flap to reconstruct complicated defects of the long fingers.


METHODS
We are reporting our experience in eight cases (seven performed in emergency) where such a flap was used to cover dorsal traumatic skin defects of the long fingers. The average age was 40.3 years, ranging from 25 to 67 years. All the patients were males, seven of them had a job at the time of injury and the last one had already retired when injured.


RESULTS
All the eight flaps survived, sometimes with minor complications. Only one case developed a whole-thickness distal necrosis treated successfully by regular dressings. In one case, a Z-plasty was performed to correct a retraction in the 2nd web-space two months after surgery.


CONCLUSIONS
Many flaps have been described to cover dorsal skin defects in the fingers. All of them display some advantages and some disadvantages. The use of this flap allows coverage of vast skin defects and thereby early finger mobilisation. The surgical technique is rather easy, and it does not require microsurgical experience. Skin grafting to cover donor site is not always necessary.
Gérard
F
F
Unité de chirurgie de la main et du membre supérieur, clinique Saint-Joseph 35300 Fougères, France.
Obert
L
L
Pem
R
R
Tropet
Y
Y
D000062:Accidents, Occupational; D000328:Adult; D000368:Aged; D004630:Emergencies; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000009:adverse effects; D013536:Suture Techniques; D016896:Treatment Outcome