title: Vascularized tendon incorporated in reverse homodigital and heterodigital island flaps for the reconstruction of dorsal digital defects.
abstract: BACKGROUND
  An adequate range of motion (ROM) of the distal interphalangeal (DIP) joint is indispensable for fine motor skills of the hand. Reconstruction of extended skin and tendon loss of the distal phalanx is often challenging for surgeons and may lead to functional impairment of the injured finger. This article presents an option for a one-step functional and esthetical reconstruction of dorsal digital defects using combined island flaps.
  
  
  METHODS
  Vascularized tendons were harvested incorporated in reverse homodigital and heterodigital island flaps to treat skin and extensor tendon loss of patients over their DIP joints. In a 6-month follow-up, we evaluated the active ROM and fine motor skills of the involved fingers as well as the patients' satisfaction.
  
  
  RESULTS
  Six months postoperatively satisfactory functional and sensory results of the donor site finger have been reported. The mean ROM for the recipient finger was 0°/25° for the DIP joint. All flaps remained viable and full finger length was preserved. Patients stated adequate till high satisfaction with respect to operation time, pain, and finger appearance.
  
  
  CONCLUSIONS
  The vascularized tendon incorporated in reverse island flaps provides a sufficient method to restore function of the DIP joint after complex injury and prevents finger deformity, arthrodesis, or amputation.
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Tuebingen, Germany. a.rahmanian@web.de
authors.forename: Afshin
authors.initials: A
authors.lastname: Rahmanian-Schwarz
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schiefer
authors.forename: Amro
authors.initials: A
authors.lastname: Amr
authors.forename: Hans-Eberhard
authors.initials: HE
authors.lastname: Schaller
authors.forename: Bernhard
authors.initials: B
authors.lastname: Hirt
mesh_terms: D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005385:Fingers / Q000098:blood supply / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013710:Tendons / Q000098:blood supply / Q000637:transplantation*; D016896:Treatment Outcome; D014463:Ultrasonography