[Repair of soft-tissue defects on volar aspect of fingers with medial plantar venous flap].

OBJECTIVE: To investigate the operative procedure and the short-term therapeutic effects of medial plantar venous flaps for restoration of soft-tissue defects on the volar aspect of fingers.

METHODS: From May 2007 to July 2009, 13 cases (15 fingers) ofvolar soft tissue defects were treated with medial plantar venous flaps, including 7 males (9 fingers) and 6 females (6 fingers) with an average age of 30 years (range, 17-55 years). Soft tissue defects were caused by electric saws in 4 cases (5 fingers), by crush injury in 6 cases (6 fingers), and by burned scar removal in 3 cases (4 fingers). The size of soft tissue defects ranged from 1.0 cm x 0.9 cm to 5.8 cm x 3.3 cm, included 5 thumbs, 3 index fingers, 3 little fingers, 2 ring fingers, and 2 middle fingers. The emergency surgical treatment was performed in 10 traumatic cases after 2 to 12 hours (4 hours on average); and the elective surgical treatment was performed in the other 3 cases of scar after burn. The 15 medial plantar venous flaps, with size of 1.0 cm x 1.0 cm to 6.0 cm x 3.5 cm, were harvested to restore defects. Of them, 12 venous flaps had 1 superficial vein and the other 3 had 2 veins; and the veins of 13 venous flaps bridged a single digital artery and the veins of the other 2 flaps bridged both arteries. The donor sites were sutured directly or were covered with skin graft.

RESULTS: All 15 venous flaps survived completely, and the donor and recipient sites healed by first intention. Eleven cases (11 fingers) were followed up for 2 to 12 months. The texture and color of the flaps were similar to those of adjacent normal skin with a satisfactory appearance. The two-point discrimination was 6-9 mm. According to criterion for joint junction of total active range of motion/total active range of flexion, the results were excellent in 10 cases and good in 1 case; the excellent and good rate was 100%.

CONCLUSION: The medial plantar venous flap has advantages of easy-to-operate, rich blood supply and high survival rate. So it is an ideal and reliable choice for volar soft tissue defects of fingers.