title: Double reverse-flow island flaps for two adjacent finger tissue defect.
abstract: BACKGROUND
  Soft-tissue reconstruction of fingertip injuries remains a challenge for hand surgery. Tissue loss of multiple digits is a serious problem for hand surgeons. Surgical possibilities include regional, distant and local flaps. In this study, five patients presented with tissue loss of two adjacent fingers and were treated by double reverse-flow island flaps.
  
  
  METHODS
  The surgical technique is an application of the reverse-flow homodigital island flap for two adjacent finger tissue defects. Instead of one flap, double island flaps are applied to two adjacent finger tissue defects. The flaps are raised from the lateral or medial palmar surface of the proximal phalanx level. Anastomoses between the radial and ulnar digital arteries at the distal interphalangeal joint level are preserved.
  
  
  RESULTS
  Three of the patients had tissue defects at the fingertip. In these cases, digital nerve anastomosis with the counter lateral digital nerve made the flaps sensitive. In two patients, the tissue defect was on the dorsum of the middle phalanx level. In these cases, the flaps were non-sensitive. Neither infection nor flap failure was seen in the patients. Sensitive function was satisfactory in fingertip applications.
  
  
  CONCLUSIONS
  The reverse-flow homodigital island flap is a commonly used surgical technique for tissue defects in the fingers. The double reverse-flow island flaps involve the application of this technique for two adjacent fingers. The important point in the surgical technique is that the vascular supply of the two flaps should originate from the same common palmar digital artery. This technique offers a possibility to repair the defects of two adjacent fingers.
authors.affiliation: Faculty of Medicine, Department of Orthopedic Surgery, University of Uludag, 16059, Görükle, Bursa, Turkey. kaleli@uludag.edu.tr
authors.forename: Tufan
authors.initials: T
authors.lastname: Kaleli
authors.forename: Salim
authors.initials: S
authors.lastname: Ersozlu
authors.forename: Cagatay
authors.initials: C
authors.lastname: Ozturk
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D013524:Surgical Flaps / Q000098:blood supply*; D014947:Wounds and Injuries / Q000601:surgery*