Reverse dorsal digital island flap.

The anatomic and clinical bases for a reliable and versatile homodigital flap for covering difficult distal dorsal and dorsolateral wounds of the long fingers are presented. This one-step procedure, which uses the dorsal skin of the first or second phalanx transposed as a reverse island flap, preserving the collateral nerve and artery to the fingertip, has proved valuable in salvaging the severely injured digits of nine patients (for a total of 12 flaps). It would seem to be a relatively simple way of achieving early recovery because it does not require distant flap reconstruction, the immobilization of adjacent digits, or homodigital flaps that might jeopardize an already injured finger. Furthermore, it reduces the time of hospitalization and improves patient welfare.