title: Reconstruction of multiple fingertip injuries with reverse flow homodigital flap.
abstract: OBJECTIVE
  Hand trauma may lead to multiple fingertip defects, causing functional restrictions. We evaluated the use of reverse-flow homodigital flap reconstruction of the distal phalanx and pulp defects associated with multiple finger injuries.
  
  
  METHODS
  We retrospectively evaluated 11 male patients who presented at our emergency department (January 2011-March 2013) with multiple fingertip injuries and who were treated with a reverse-flow homodigital flap. Evaluations included age, sex, defect size, flap survival rate, complications, cold intolerance, two-point discrimination, range of motion (ROM), quick disabilities of the arm, shoulder, and hand (DASH) score, and return to work time.
  
  
  RESULTS
  Completely, 22 reverse-flow homodigital flaps were applied to at least two fingertip injuries at the distal phalanx. Ten flaps survived postoperatively. The exception was partial flap loss on one finger. The mean follow-up was 14.2 months. At the final follow-up, the mean static two-point discrimination value was 10.3mm. Mean ROMs of interphalangeal joints were 65.31° (distal) and 105.77° (proximal). Donor sites were covered with full-thickness skin grafts from the wrist or antecubital area. There were no complications related to the donor site and no development of cold intolerance in any finger. The mean quick DASH score was 4.12. All patients returned to work in an average of 8.3 weeks.
  
  
  CONCLUSIONS
  The reconstruction of multiple fingertip injuries with reverse-flow homodigital flaps is a safe, effective method that can be combined with other local finger flaps. These flaps can be applied to two consecutive fingers without reducing finger length or function.
authors.affiliation: Selçuk University, Selçuk School of Medicine, Department of Orthopaedics and Traumatology, Campus of Alaeddin Keykubat, Selçuklu 42075, Konya, Turkey.
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Acar
authors.affiliation: Ordu University, School of Medicine, Department of Orthopaedics and Traumatology, Campus of Cumhuriyet, Ordu 52200, Turkey. Electronic address: dryg@windowslive.com.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Güzel
authors.affiliation: Selçuk University, Selçuk School of Medicine, Department of Orthopaedics and Traumatology, Campus of Alaeddin Keykubat, Selçuklu 42075, Konya, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Güleç
authors.affiliation: Necmettin Erbakan University, Meram School of Medicine, Department of Orthopaedics and Traumatology, Campus of Meram, Meram 42080, Konya, Turkey.
authors.forename: Faik
authors.initials: F
authors.lastname: Türkmen
authors.affiliation: Selçuk University, Selçuk School of Medicine, Department of Orthopaedics and Traumatology, Campus of Alaeddin Keykubat, Selçuklu 42075, Konya, Turkey.
authors.forename: Ömer F
authors.initials: ÖF
authors.lastname: Erkoçak
authors.affiliation: Selçuk University, Selçuk School of Medicine, Department of Orthopaedics and Traumatology, Campus of Alaeddin Keykubat, Selçuklu 42075, Konya, Turkey.
authors.forename: Güney
authors.initials: G
authors.lastname: Yılmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D062707:Return to Work; D012677:Sensation; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation; D016896:Treatment Outcome
keywords: Distal injuries; Homodigital flaps; Island flaps; Multiple finger defects