Clinical application of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery

Objective To explore the operative method and clinical efficacy of retrograde transfer of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery for repair of fingertip defect of the same finger. Methods From May 2014 to August 2016, 9 cases (9 fingers) of fingertip soft tissue defects were treated by retrograde transfer of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery. All the patients had bone exposure. The defect area ranged from 1.2 cm×1.3 cm to 1.7 cm×2.0 cm. Results All the flaps survived uneventfully with primary healing in the wounds. The postoperative follow-up period ranged from 8 to 14 months, with an average of 11 months. The function and appearance recovery of fingers were satisfactory. The fingertip flaps were full without bulky pedicle. The sensory function recovered well. The fingertip two-point discrimination was 5 to 8 mm. Conclusion The dorsal proximal phalanx fasciocutaneous island flaps with anastomosis of cutaneous branch of the digital artery have reliable blood supply without sacrificing the digital artery and little influence on the donor site. It is suitable for repairing fingertip defects with good appearance and sensory recovery. Key words: Finger injuries; Surgical flaps; Cutaneous branch of the digital artery; Fingertip defects