Reconstruction of digital composite defects via a free chimeric bone flap based on the superficial palmar branch of the radial artery

Objective To explore the clinical effect of free chimeric bone flap based on the superficial palmar branch of radial artery to repair finger composite tissue defects. Methods From July, 2013 to January, 2016, 9 cases of finger composite tissue defect were repaired by free chimeric bone flap from the wrist crease area. The flap and bone flap were taken with the superficial palmar branch of the radial artery during the operation. The area of the flap was 1.5 cm × 4.0 cm to 3.5 cm× 6.5 cm, and the size of the bone flaps were 0.5 cm × 1.0 cm × 1.5 cm to 1.0 cm × 2.5 cm × 3.5 cm. Regular followed-up was done after the operation. Results Nine cases of chimeric bone flap survived well, and the average healing time of bone flap was 1.6(1.5-3.0) months. The function and appearance of the patients recovered well. The scars on the donor area was slight. The average two-point discrimination of flap was 6.6(5.3 to 8.6) mm at 6 months after operation. According to the Evaluation Criteria of Thumb and Finger Reconstructive Function Assessment of the Upper Limb of the Chinese Medical Association, 7 cases were superior, 1 was good, 1 was medium. Conclusion The free chimeric bone flap pedicled with superficial palmar branch of radial artery can simultaneously repair soft tissue and bone defects. It helps shorten the course of disease and speed up the recovery of finger function. It is a new choice to repair finger tissue defects. Key words: Finger injuries; Chimenic bone flaps; Superficial palmar branch of radial artery; Microsurgical operation