title: Reconstruction of a large soft-tissue defect in the single finger using the modified cross-finger flap.
abstract: BACKGROUND
  Providing soft-tissue coverage for a large defect in the single finger presents marked functional and aesthetic challenges. This article describes the reconstruction of such injuries using a modified cross-finger flap, and it reports the results of the use of the flap.
  
  
  METHODS
  Over 5 years, a retrospective study was conducted with 22 patients who had a large defect in the single finger. The mean size of soft-tissue defects was 4.3 ± 0.4 cm in length and 1.8 ± 0.4 cm in width. The defects were reconstructed with a modified cross-finger flap.
  
  
  RESULTS
  Full-flap survival was achieved in 20 fingers. Partial distal-flap necrosis occurred in two fingers, which healed without surgical intervention. We collected the data of the sensory restoration in 20 flaps where sensory return was considered important. Based on the modified American Society for Surgery of the Hand guidelines for the stratification of a two-point discrimination (2PD), 17 (85%) flaps achieved excellent and good results and only three (15%) flaps obtained fair result. No significant difference was found in joint motion between the donor finger and the contralateral side. According to the Michigan Hand Outcomes Questionnaire, 11 patients were satisfied, nine were somewhat satisfied and two were neither satisfied nor dissatisfied with the functional recovery of the reconstructed finger.
  
  
  CONCLUSIONS
  The modified cross-finger flap is versatile and useful for the coverage of the relatively large defect in the single finger, especially when sensory reconstruction is needed.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: The Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, PR China; Hand Surgery Department, The Second Hospital of Tangshan, Tangshan 063000, Hebei, PR China.
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.affiliation: The Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, PR China. Electronic address: tangpeifubeijing@163.com.
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
authors.affiliation: The Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, PR China.
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D004954:Esthetics; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000098:blood supply / Q000294:innervation; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000601:surgery*; D014950:Wounds, Penetrating / Q000601:surgery*; D055815:Young Adult
keywords: Cross-finger flap; Dorsal branch of the digital artery; Dorsal branch of the digital nerve; Soft-tissue defects