title: [Repair of finger soft tissue defect with island flap based on vascular chain of cutaneous branch of dorsal metacarpal artery].
abstract: OBJECTIVE
  To investigate the operative procedure and the clinical results of the island flap based on the vascular chain of the cutaneous branch of dorsal metacarpal artery for repairing finger soft tissue defect.
  
  
  METHODS
  Between January 2008 and March 2012, 28 cases of tissue defect of fingers (32 fingers) were repaired with the island flaps based on the vascular chain of the cutaneous branch of dorsal metacarpal artery. There were 20 males (23 fingers) and 8 females (9 fingers), with an average age of 29.5 years (range, 14-67 years). The injury causes included 14 cases of crush injury, 6 cases of pressing injury, 5 cases of cutting injury, and 3 cases of avulsion injury. The locations included 10 index fingers, 13 long fingers, 6 ring fingers, and 3 little fingers. There were 9 defects of proximal segment, 12 defects of middle segment, and 11 defects of distal segment. The area of defect ranged from 1.0 cm x 0.8 cm to 5.2 cm x 3.5 cm. The disease duration was 1 hour to 15 days. The area of flaps ranged from 1.2 cm x 1.0 cm to 5.5 cm x 3.8 cm. The donors were closed by suture or were repaired with skin graft.
  
  
  RESULTS
  Tense blister occurred in 3 cases, which was cured after dressing change; the other flaps survived. Wound obtained primary healing. Twenty-five patients (27 fingers) were followed up 6-25 months (mean, 16.8 months). The flaps had soft texture and satisfactory appearance. Two point discrimination was 6-9 mm (mean, 7.7 mm) at 6 months after operation. The total active movement of fingers was 105-230 degrees (mean, 204.6 degrees). The results were excellent in 17 fingers, good in 8 fingers, and fair in 2 fingers with an excellent and good rate of 92.6%.
  
  
  CONCLUSIONS
  The island flap based on the vascular chain of the cutaneous branch of dorsal metacarpal artery has the advantages of the deverting point from the dorsal point to the palm, the extended vessel pedicle, and expanded operation indications, so it is not necessary to cut the dorsal metacarpal artery. It can be used to repair finger tissue defect.
authors.affiliation: Department of Orthopedics, Traditional Chinese Medicine Hospital of Tangshan, Tangshan Hebei, 063000, P.R.China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Zhang
authors.forename: Wenlong
authors.initials: W
authors.lastname: Zhang
authors.forename: Cheng
authors.initials: C
authors.lastname: Jiao
authors.forename: Yajing
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000293:injuries / Q000601:surgery; D005260:Female; D005383:Finger Injuries / Q000209:etiology / Q000601:surgery*; D005385:Fingers / Q000098:blood supply / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000098:blood supply / Q000601:surgery; D008663:Metacarpus / Q000098:blood supply / Q000601:surgery*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D017695:Soft Tissue Injuries / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D013537:Sutures; D016896:Treatment Outcome; D055815:Young Adult