The dorsal middle phalangeal finger flap.

A versatile one-stage neurovascular flap from the dorsum of the middle phalanx of the finger is described. The flap is based on one proper digital artery, the venous network about its adventitia and the dorsal branches of the proper palmar digital nerves bilaterally. The characteristics of the flap include a size up to 3 by 6 cm, an arterio-venous pedicle up to 12 cm in length, an arc of rotation around the superficial palmar arch, discriminative sensibility, and comparably low donor morbidity. The flap may be transposed on its vascular pedicle with or without nerve suture. Furthermore it is ideally suited as a thin and pliable flow-through flap in digital replantation/revascularization. Finally, it may be utilized as a free neurovascular flap.