Reverse digital artery cross-finger flap for reconstruction of failed finger replantation

Kim, Dong Hee; Seo, Kyu Bum; Lee, Sang Hyun; Lee, Heejin; Kang, Hong Je

doi:10.1177/2309499018816773

Cited by 10 publications

(9 citation statements)

References 21 publications

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“…(1) The digital dorsal fascial island flap and the cross-finger flap pedicle include the dorsal branch of the proper digital artery of the middle finger segment and surrounding fascial tissues, with rich blood supply, reliable blood circulation, and high survival rate. (2) The flap is easy to dissect without damaging the main nerve and vessels ( 15 , 24 ). (3) The skin flap was removed from the tissue around the adjacent wound.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

et al. 2022

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BackgroundTo explore the clinical effect of digital dorsal fascial island flap combined with crossfinger flap to repair distal degloving injury and sensory reconstruction.MethodsA total of 19 patients with distal fingertip degloving injuries treated with digital dorsal fascial island flap combined with crossfinger flap in our hospital from April 2018 to August 2020 were retrospectively included. Semmes–Weinstein (SW) monofilament and static two-point discrimination (S-2PD) tests, active range-of-motion (ROM) of the fingers, cold intolerance, visual analog scale (VAS) score patient complications, and patient satisfaction were evaluated.ResultsFive cases with post-operative flap blisters were treated at the time of dressing changes until successful scab formation. Three cases with post-operative arterial crisis of finger arterial dorsal branch vessel were relieved after suture removal and tension reduction. All other skin flaps and skin grafts survived. Nineteen patients received follow-up between 3 and 26 months (average 14.6 months). The active ROM of metacarpophalangeal (MCP) and interphalangeal (IP) joints of the injured fingers were satisfactory.ConclusionThe digital dorsal fascial island flap combined with the crossfinger flap for repairing the distal degloving injury of the distal segment of the finger is a good surgical method, which is simple and easy to operate, can repair a large area of soft tissue defect, and obtain a satisfactory effect.

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Section: Discussionmentioning

confidence: 99%

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

et al. 2022

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“…Kim [78] measured the long term outcomes of reverse digital artery cross finger flap done for defect cover over 11 failed index and little finger replants. In all ca-…”

Section: Discussionmentioning

confidence: 99%

Timeline of Cross Finger Flap: From its Inception to its Future

Chakraborty¹,

Acharya²,

Midya³

et al. 2021

Trauma Cases Rev

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Since the first description of the cross-finger flap in 1950 for finger injury defect cover, over the last 70 years it has been tremendously explored and has underwent innumerable refinements and modifications. Whether used alone or in combination with other flaps for the reconstruction of finger defects, traumatic or non-traumatic, cross finger flap has proven its worth as a workhorse for finger reconstruction. Despite a handful of innate disadvantages, it has given excellent sensory, functional, and aesthetic outcomes in vast majority of studies. This article has been an attempt to reveal the entire rich journey and inexhaustible history of cross finger flap. With such a grandiose potential, it only seems that the cross finger flap will be continuously evolving over time and keep serving mankind in better ways.

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“…If the bone is exposed, shortened primary, local, or pedicled flaps or free tissue transfers can be used. [11] It is possible to repair dorsal defects with a homodigital subcutaneous flap, [11] proximalbased axial digital artery transposition flap, [12] reverseflow digital artery flap, [13] and reversed cross-finger subcutaneous flaps. [7,8,14] Atasoy [3] reported four patients with nail bed defect treated by axial pattern adipofascial flap after the reversed dermis flap described by Pakiam.…”

Section: Discussionmentioning

confidence: 99%

“…If the bone is exposed, shortened primary, local, or pedicled flaps or free tissue transfers can be used. [ 11 ] It is possible to repair dorsal defects with a homodigital subcutaneous flap,[ 11 ] proximal- based axial digital artery transposition flap,[ 12 ] reverse- flow digital artery flap,[ 13 ] and reversed cross-finger subcutaneous flaps. [ 7 , 8 , 14 ]…”

Section: Discussionmentioning

confidence: 99%

Is the cross-finger flap a good option at the extensor zone defect?

Ekinci

2020

Jt Dis Relat Surg

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Reconstructions of dorsal digital finger injuries with or without tendon defect often cause serious difficulties for surgeons as they also affect the extensor mechanism. Although local, regional, or free flaps may be used in the reconstruction of these defects, the results may not always be satisfactory. Various flaps have been described in the literature that can be used in such injuries. [1-5] Although various flaps have been defined for adequate coverage of dorsal finger defects, these flaps may not result in cosmetic and functional satisfaction due to volume mismatch. [6] In order to minimize the problems of the donor finger, the opposite cross finger is defined as the second, third, fourth, and fifth fingers. It is a good alternative to close defects on the side of the middle and distal phalanx. This method, which is not difficult for the surgeon, may be our first choice to treat such defects [1,7,8] Therefore, in this study, we aimed to evaluate the surgical and clinical outcomes of reversed crossfinger subcutaneous flaps applied to patients with dorsal digital defects. Objectives: This study aims to evaluate the surgical and clinical outcomes of reversed cross-finger subcutaneous flaps applied to patients with dorsal digital defects. Patients and methods: Between January 2015 and September 2018, 25 (22 males, 3 females; mean age 35.6±11.6 years; range, 19 to 65 years) out of 27 patients under prospective follow-up with finger dorsal digital defect were retrospectively screened and included in the study. The data, obtained by the same two surgeons at six months postoperatively in patients who had undergone reversed cross-finger subcutaneous flaps surgery, concerned cold intolerance, a static two-point separation test, and functional results using range of motion (ROM) and Quick Disabilities of the Arm, Shoulder and Hand (DASH) scoring. Results: The majority of the patients presented with occupational injury (64%), most commonly to the dominant hand (76%) and the fourth finger (36%) most frequently. Seven patients with extensor tendon defects underwent reconstruction with a palmaris longus autograft. At the six-week postoperative follow-up, all flaps were live, the donor site had no morbidity, and no additional intervention was performed. There was no statistically significant difference in finger joint ROM (p>0.05). Cold intolerance was observed in 14 patients (56%). The mean dynamic two-point distinction was 6.0±0.7 mm and the QuickDASH score was 22.3±5.0. Conclusion: Due to reasons such as minimal donor site morbidity, satisfactory functional finger outcomes, and easy applicability, reversed cross-finger subcutaneous flap is a good option for reconstruction of defects in the dorsal aspect of the finger with or without extensor mechanism defects.

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Reverse digital artery cross-finger flap for reconstruction of failed finger replantation

Cited by 10 publications

References 21 publications

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

Timeline of Cross Finger Flap: From its Inception to its Future

Is the cross-finger flap a good option at the extensor zone defect?

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