Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator

Abstract

Background. The hand is the most frequently injured body part. Injuries to the fingertips are among the most common hand injuries. In this article an anterograde pedicle flap based on the dorsal branches of proper digital artery from the dorsum of the middle phalanx was used to reconstruct the fingertip defect as described by Peng Wei MD in a single stage to provide a durable, sensate coverage with the least possible complications. Aim of study. To introduce and assess the result and long term follow up of using an anterograde pedicle flap based on the dorsal branches of proper digital artery from the dorsum of middle phalanx. Patients and method. A total of twelve male patients were presented to us between November 2016 and January 2018. All of them had history of fingertip injuries and had undergone reconstruction using anterograde pedicle flap based on the dorsal branches of proper digital artery from the dorsum of the middle phalanx” the period of follow up ranged from one month to six months with an average of three months. Result. In this study 12 patients presented with fingertip defect were surgically treated by using an anterograde pedicle flap based on the dorsal perforator. All the patient had satisfactory result with good pliable contour coverage of their injured fingertip with no restriction of finger movements. Conclusion. The use of anterograde island flap based on the dorsal branches of proper digital artery from the dorsum of middle phalanx is suitable for reconstruction of fingertip defects of various amputation planes, it provided good contour texture with preservation of digital artery and nerve, it also provides patient with acceptable fingertip appearance.One of the major drawbacks of this procedure is that it requires tedious and meticulous dissection and that donor site requires full-thickness skin graft, which leads to donor site morbidity and scarring. Keywords.