Innervated Dorsal Digital Artery Propeller Perforator Flaps in One-Stage Reconstruction of Fingertip Defects: Experience With 45 Cases

Abstract

Purpose

We describe a technique to reconstruct fingertip defects with dorsal digital artery perforator flaps innervated with terminal branches of the proper digital nerve in a propeller manner.

Methods

To reconstruct fingertip defects, a dorsal digital artery perforator flap innervated with terminal branches of the proper digital nerve was performed. This retrospective study includes 44 fingers and 4 thumbs in 45 cases. Thirty-seven males and eight females with a mean age of 43.7 years were enrolled. The sizes of large paddles ranged from 2.0 cm × 1.3 cm to 6.0 cm × 1.6 cm, and the sizes of little paddles ranged from 0.4 cm × 0.6 cm to 2.1 cm × 0.4 cm. All flaps were harvested from the injured fingers. Donor sites were primarily closed in all patients.

Results

All flaps survived without major complications, except two cases with partial epidermis necrosis that healed after dressing changes. The mean follow-up period was 14.9 months. Postoperative appearance and texture of the flaps were close to normal, and no deficiency was observed in the sensory functions, although partial recovery of nociceptive and tactile sensation was detected in three patients. Postoperative extension and flexion functions of the fingers were assessed using active range of motion, with all patients demonstrating values within standard parameters and showing no signs of tendon adhesions or scar contractures.

Conclusions

The dorsal digital artery propeller perforator flap innervated with terminal branches of the proper digital nerve is a reliable and relatively simple flap for the one-stage reconstruction of fingertip defects.