[Neurovascular free flap based on dorsal branch of digital artery of ring finger for finger pulp defect].
OBJECTIVE
To investigate the surgical procedures and clinical outcomes of the neurovascular free flap based on dorsal branch of digital artery of ring finger graft for repair of finger pulp defect.


METHODS
From February 2006 to May 2009, 11 cases (11 fingers) of finger pulp defect with tendon and bone exposure were treated, including 8 males and 3 females with an average age of 29 years (range, 23-40 years). The defect locations were thumb in 2 cases, index finger in 5 cases, and middle finger in 4 cases. The defect size ranged from 1.0 cm x 1.0 cm to 2.5 cm x 2.0 cm. The time from injury to operation was 1-9 hours. The flap size ranged from 1.5 cm x 1.5 cm to 3.0 cm x 2.5 cm. Five flaps carried the dorsal branch of digital nerve, 6 flaps carried nervi digital dorsales. The flaps were cut from proximal radial dorsal ring finger in 4 cases and from proximal ulnar dorsal ring finger in 7 cases. Defect of donor site was repaired with full-thickness skin grafting.


RESULTS
All flaps and grafted skins survived; wound and incision of donor site achieved healing by first intention. Eleven patients were followed up 6 to 24 months with an average of 12 months. The other finger flaps had good texture and shape except for 1 flap with slightly bloated. The activities of finger distal interphalangeal joint were normal, the two-point discrimination of finger pulp was 7-12 mm. The extension and flexion activities of donor fingers were normal, the ringlike thread scar left at the donor site.


CONCLUSIONS
It is an ideal method to use the neurovascular free flap based on dorsal branch of digital artery of ring finger graft for repair of finger pulp defect, which has the advantages of simple operation, good appearance, and functional recovery.
Ju
Jihui
J
Department of Hand Surgery, Ruihua Hospital of Suzhou City, Suzhou Jiangsu 215128, PR China. jjh2006@263.net
Jin
Guangzhe
G
Zhou
Rong
R
Li
Lei
L
Zhao
Qiang
Q
Liu
Yuefei
Y
Li
Jianning
J
Wei
Cheng
C
Hou
Ruixing
R
D000328:Adult; D001158:Arteries / Q000637:transplantation*; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000098:blood supply; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation; D016896:Treatment Outcome; D055815:Young Adult