Repairing soft tissue defect of thumb tips in infants by using the first dorsal metacarpal radial artery flaps along with anatomosing of nerves and veins

Objective To investigate the surgical methods and clinical effect of repairing the thumb tip defects in infants by applying the reversed first dorsal metacarpal radial artery island flaps along with anatomosing of nerves and veins. Methods Twenty-one cases with soft tissue defects of thumb tips caused by trauma were admitted from August, 2015 to August, 2017. The first dorsal metacarpal radial island artery flaps were transplanted reversely to repair the defects along with the anatomosis of nerves and veins. Among all the cases, the range of defect area was 2.0 cm×1.8 cm-3.0 cm×2.5 cm. The area range of the flap harvested during the surgery was 2.2 cm×2.0 cm-3.2 cm×2.7 cm. The regular post-operative followed-up was performed. Results All flaps survival after the surgeries, and the wounds were I-staged healing. All cases were followed-up by 3-18 months, and the average time was 7 months. The appearance and quality of the flaps were good. The range of motion of the metacarpophalangeal joints and interphalangeal joints was normal. According to the Upper Extremity Functional Evaluation Tentative Criteria set up by Hand Surgery Branch of Chinese Medical Association, 14 cases were excellent, 5 case was good, and 2 cases were fair. Conclusion The surgery of using the first dorsal metacarpal radial reversed island artery flap to repair the de fect of thumb tip in infant, along with the anatomosis of nerve and vein, is a good method in repairing the defects due to its ease of operation, achievement of plump of finger tip and good recovery of appearance and sensation after the surgery. Key words: First dorsal metacarpal artery; Flap transplant; Finger tips defect; Thumb; Infants