A reversed digital artery island flap for the treatment of fingertip injuries.

A series of complex fingertip injuries managed with a reversed digital artery island flap is presented. An island of skin on the side of the proximal phalanx can be elevated on a digital arterial pedicle and rotated to the fingertip to provide abundant skin and subcutaneous coverage for acute or chronic deficits. The flap receives retrograde flow from its ipsilateral digital artery after passage through dorsal and palmar vascular plexuses at the middle and distal phalangeal level. Thirteen flaps were performed on eleven patients with no loss of any portion of the flap. The advantages of this procedure include a reconstruction that necessitates surgery only on the injured digit, allowing for the treatment of single or multiple fingertip injuries that provides functional sensation in the reconstructed fingertip without causing loss of motion.