Reconstruction of distal phalangeal injuries with the reverse homodigital island flap.
Reconstruction of extensive distal phalangeal defects with exposure of tendon, bone, or joint can be particularly a difficult problem. For assessment of the value of the reverse homodigital island flap patients with distal phalangeal avulsion and crush injuries who were treated from January 2005 to April 2006 were analysed retrospectively. Main outcome measurements included flap survival rate, sensory restoration, occurrence of cold intolerance, length of occupational disability, and joint mobility. Eleven patients were included in the study. Only one patient suffered from venous congestion with partial flap necrosis, requiring debridement with subsequent skin grafting. The minimum follow-up was 6 months. The static 2-point discrimination had a mean value of 9 mm. None of our patients complained of cold intolerance or residual joint contracture. All patients returned to full occupational activity within an average time period of 4.5 weeks. In conclusion, the reverse homodigital island flap is an excellent option for 1-stage reconstruction of distal phalangeal defects.
Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Freiburg, Germany. arash.momeni@googlemail.com
Arash
A
Momeni
Horst
H
Zajonc
Ziad
Z
Kalash
G Björn
GB
Stark
Holger
H
Bannasch
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D003646:Debridement; D004954:Esthetics; D005383:Finger Injuries / Q000601:surgery*; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012677:Sensation / Q000502:physiology; D013524:Surgical Flaps / Q000098:blood supply*