First Dorsal Metatarsal Artery Free Flap for Finger Coverage Defect: A Case Report

Abstract

Severe finger injuries with loss of substance and exposure of noble structures are a challenge to avoid amputation. These situations have prompted the development of many local axial flaps to save the digit. Customized free flaps have also been described to provide adequate and good-quality coverage. We present the case of a patient with a severe injury to the ring finger with bone exposure and tendinous damage, with a coverage defect of 4 × 4 cm. The patient underwent reconstruction with a free flap from the foot, taking the first intermetatarsal artery as the donor vascular axis. The patient kept his finger with mobility at the expense of the proximal interphalangeal (PIP) joint, with good-quality skin, firm clamp, and no pain. The donor area did not present complications. In the hands of a trained team, with adequate indication, these flaps achieve a good esthetic and functional result.

Level of Evidence 3.

Keywords

coverage defect - free flap - metatarsal artery - upper extremity reconstruction - microsurgery

Publication History

Received: 21 December 2020

Accepted: 17 May 2022

Article published online:
03 October 2022

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