title: Repair of dorsal defects over the middle phalanx and proximal interphalangeal joint with a transposition flap from the dorsum of the proximal phalanx.
abstract: OBJECTIVE
  We report the use of a transposition flap raised from the dorsum of the proximal phalanx for coverage of soft tissue defects on the dorsum of the middle phalanx and proximal interphalangeal joint involvement.
  
  
  METHODS
  From October 2005 to November 2008, we treated 16 digits in 16 patients in our unit. There were avulsion (n = 3), third-degree burn (n = 7), and crush (n = 6) injuries. The mean flap size was 2.3 × 1.8 cm (range, 1.8 × 1.7 cm to 2.6 × 2.3 cm). The mean pedicle length was 1.7 cm (range, 1.0-2.3 cm). At follow-up, we measured active joint motion. The scar pain at the donor site was determined by the patient's self-reported assessment. We measured cold intolerance using the self-administered Cold Intolerance Severity Score questionnaire.
  
  
  RESULTS
  All flaps survived completely. At the final follow-up after 2 years, the mean active motion of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 90°, 105°, and 57°, respectively. All scars on the donor sites were painless. All patients were mildly cold intolerant.
  
  
  CONCLUSIONS
  This transposition flap raised from the dorsum of proximal phalanx is useful and reliable for coverage of a dorsal defect over the middle phalanx and proximal interphalangeal joint with minimal donor site morbidity.
authors.affiliation: Department of Hand and Foot Surgery, No. 252 Hospital of Chinese People's Liberation Army, Baoding, Hebei, China. fengyagao@sohu.cn
authors.forename: Yagao
authors.initials: Y
authors.lastname: Feng
authors.forename: Ming
authors.initials: M
authors.lastname: Hu
authors.forename: Houjun
authors.initials: H
authors.lastname: Yan
authors.forename: Xiangning
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhongsheng
authors.initials: Z
authors.lastname: Tao
authors.forename: Zhenmu
authors.initials: Z
authors.lastname: Lv
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply*; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult