[Repair of soft tissue defect in finger with modified reverse dorsal digital fascia flap]

Zhian Li, Zhenwu Li, Guiping Zhang
Chinese Journal of Reparative and Reconstructive Surgery 2009, 23 (6): 660-2

OBJECTIVE: To investigate the operative method of repairing soft tissue defect of finger with modified reverse dorsal digital fascia flap and its clinical effect of preventing and treating venous crisis.

METHODS: From February 2005 to March 2007, 19 cases (22 fingers) with soft tissue defect of finger were treated, including 14 males (17 fingers) and 5 females (5 fingers) aged 2-62 years old (median 26 years old). There were 8 cases of cutting injury, 6 cases of crush injury, 4 cases of avulsion injury, and 1 case of hot crush injury, involving 3 thumbs, 7 index fingers, 6 middle fingers, 4 ring fingers and 2 little fingers. The size of soft tissue defect was 1.5 cm x 0.8 cm-5.5 cm x 1.5 cm, and the time from injury to operation was 2-11 hours (average 7 hours). The axis of flaps was the line of transverse striation of fingers via dominant artery. The flaps were deflected dorsally, as "b" or "d", to cover the wounds. Reverse dorsal digital fascia flaps 1.8 cm x 1.0 cm-6.0 cm x 2.0 cm in size were Radopted to repair the defects. The donor site underwent skin grafting fixation.

RESULTS: All flaps survived, without venous acrisis and obvious swollen. The grafted skin in the donor site all survived. All patients were followed for 6-18 months (average 11 months). Postoperatively, color and texture of the grafted flaps were similar to that of normal skin, and the pulp of the fingers was normal. The two-point discrimination was 8-11 mm, and the activities of interphalangeal joint of all injured fingers were normal.

CONCLUSION: The modified reverse dorsal digital fascia flap is ideal for repairing soft tissues defects of the fingers, and can decrease the occurrence of venous crisis.

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