Modified Innervated Radial Collateral Artery Perforator Flap for Repairing Digital Defects.

The authors presented their clinical experience and demonstrated surgical methods to reconstruct soft-tissue defects in the digit by using modified innervated radial collateral artery perforator flap. Surgical procedures that involved 12 modified innervated radial collateral artery perforator flaps were performed in 12 patients. Among the patients, two had defects in the thumbs, six had defects in the index fingers, whereas two had defects in the middle fingers, two had defects in the little fingers. The flaps ranged in size from 5.0 × 2.0 to 7.5 × 4.0 cm. The pedicle of the flap was divided and ligated below the level at which the radial collateral artery was divided into anterior and posterior branches. The recipient vessels were the proper digital artery and the palmar subcutaneous vein (n = 8), the deep branch of the ulnar palm artery (n = 4), and the venae comitantes. Nerve suture was done between the posterior cutaneous nerve of the arm and the proper digital nerve of the digital. The cosmetic appearance of the donor and recipient sites and static two-point discrimination of the operated finger were evaluated in a follow-up visit. Postoperative venous congestion happened in two cases, and both succeeded after exploration. All flaps survived, and all donor sites were closed directly, leaving a linear scar. Follow-up time ranged from 12 to 28 months. Defatting of the flap was performed in two cases during the late postoperative period. Cosmetically acceptable results were achieved for the rest of the patients. The modified innervated radial collateral artery perforator flap is a good option for reconstructing soft-tissue defects in digits.