Hongjiu Qin1, Nengfeng Ma1, Xing Du1, Jian Kong2, Haisheng Wang1, Lei Xu1, Bin Hu3. 1. Department of Hand and Foot Surgery, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan Road, Wuhu, Anhui, China. 2. Department of Orthopedics, Nantong Maternity and Child Health Care Hospital, No. 399 Shiji Road, Nantong, Jiangsu, China. 3. Department of Hand and Foot Surgery, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan Road, Wuhu, Anhui, China. Electronic address: smallshagua99@163.com.
Abstract
BACKGROUND: Reconstruction of finger-pulp defects remains a challenge, although the treatment varies widely. The homodigital island flap based on dorsal branches of the proper digital artery (PDA) is one of the most popular methods for repair of finger-pulp defects. The aim of this study was to introduce our experiences of using modified dorsolateral proximal phalangeal island flaps for reconstruction of finger-pulp defects. METHODS: From July 2016 to November 2018, 16 modified dorsolateral proximal phalangeal (MDPP) island flaps were performed for finger-pulp reconstruction. The comparison group included 11 patients treated with homodigital dorsal perforator (HDP) flaps. Flap survivals were assessed and active range of motion (ROM) of the joints, time to return to work, static 2-point discrimination and hand performance were analysed at final follow-up. RESULTS: Both the Group MDPP and the Group HDP had similar satisfactory flap survival. There were no differences in static 2-point discrimination, time to return to work and the ROM of the injured fingers. However, the Michigan Hand Outcomes Questionnaire (MHQ) summary scores of the satisfaction and aesthetics were much better in Group MDPP. CONCLUSIONS: The modified homodigital dorsolateral proximal phalangeal island flap is a reliable alternative for finger-pulp reconstruction with good functional and cosmetic outcome.
BACKGROUND: Reconstruction of finger-pulp defects remains a challenge, although the treatment varies widely. The homodigital island flap based on dorsal branches of the proper digital artery (PDA) is one of the most popular methods for repair of finger-pulp defects. The aim of this study was to introduce our experiences of using modified dorsolateral proximal phalangeal island flaps for reconstruction of finger-pulp defects. METHODS: From July 2016 to November 2018, 16 modified dorsolateral proximal phalangeal (MDPP) island flaps were performed for finger-pulp reconstruction. The comparison group included 11 patients treated with homodigital dorsal perforator (HDP) flaps. Flap survivals were assessed and active range of motion (ROM) of the joints, time to return to work, static 2-point discrimination and hand performance were analysed at final follow-up. RESULTS: Both the Group MDPP and the Group HDP had similar satisfactory flap survival. There were no differences in static 2-point discrimination, time to return to work and the ROM of the injured fingers. However, the Michigan Hand Outcomes Questionnaire (MHQ) summary scores of the satisfaction and aesthetics were much better in Group MDPP. CONCLUSIONS: The modified homodigital dorsolateral proximal phalangeal island flap is a reliable alternative for finger-pulp reconstruction with good functional and cosmetic outcome.