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DOI: 10.4103/ijps.IJPS_98_17
Why borrow from Peter when Paul can afford it? Reverse homodigital artery flap for fingertip reconstruction
Publikationsverlauf
Publikationsdatum:
09. Juli 2019 (online)
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ABSTRACT
Background: Fingertip injuries that are complicated by pulp loss, bone or tendon exposure will need a flap cover. Cross finger flap is commonly used to cover such defects. However, patients are apprehensive about injuring the uninjured finger as a donor site. Reverse homodigital artery flap (RHAF) can provide reliable vascularised cover to such defects. Aims: This study aims to assess the functional and aesthetic outcomes along with the patient satisfaction of RHAFs done for fingertip defects. Materials and Methods: RHAFs done in 18 patients operated between August 2015 and October 2016 were retrospectively analysed on flap survival, sensory recovery, range of movements, hypersensitivity, cold intolerance, flexion contracture and donor site morbidity. Results: Seventeen of the 18 flaps done survived completely. One flap had partial necrosis of 3 mm that healed conservatively. Middle finger of the right hand was the most commonly injured finger. Touch, pain and pressure sensations recovered in 8–12 weeks. Two-point discrimination was 4.5 mm at 6 months. The deficit of 5° s was present at distal interphalangeal joint during active flexion at 6 months. Cold intolerance and flexion contracture were not seen and 2 instances of hypersensitivity at 2 months got cured conservatively after 4 months. Overall satisfaction of patients was 8/10. Conclusion: RHAF provides single staged well-vascularised cover for fingertip injuries with good sensory recovery without damaging the adjacent uninjured finger. Hence, it can be a reliable flap for fingertip reconstruction in selected cases.
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REFERENCES
- 1 Lai CS, Lin SD, Yang CC. The reverse digital artery flap for fingertip reconstruction. Ann Plast Surg 1989; 22: 495-500
- 2 Cormack GC, Lamberty GB. The Arterial Anatomy of Skin Flaps. 2nd ed.. London Churchill Livingstone; 1994: p. 213-5
- 3 Regmi S, Gu JX, Zhang NC, Liu HJ. A Systematic review of outcomes and complications of primary fingertip reconstruction using reverse-flow homodigital Island flaps. Aesthetic Plast Surg 2016; 40: 277-83
- 4 Karamese M, Akatekin A, Abac M, Koplay TG, Tosun Z. Fingertip reconstruction with reverse adipofascial homodigital flap. Ann Plast Surg 2015; 75: 158-62
- 5 Huang YC, Liu Y, Chen TH. Use of homodigital reverse island flaps for distal digital reconstruction. J Trauma 2010; 68: 429-33
- 6 Alagoz MS, Uysal CA, Kerem M, Sensoz O. Reverse homodigital artery flap coverage for bone and nailbed grafts in fingertip amputations. Ann Plast Surg 2006; 56: 279-83
- 7 Yazar M, Aydin A, Kurt Yazar S, Basaran K, Güven E. Sensory recovery of the reverse homodigital island flap in fingertip reconstruction: A review of 66 cases. Acta Orthop Traumatol Turc 2010; 44: 345-51
- 8 Kayalar M, Bal E, Toros T, Ozaksar K, Sügün ST, Ademoglu Y. The results of reverse-flow island flaps in pulp reconstruction. Acta Orthop Traumatol Turc 2011; 45: 304-11
- 9 Han SK, Lee BI, Kim WK. The reverse digital artery island flap: An update. Plast Reconstr Surg 2004; 113: 1753-5
- 10 Momeni A, Zajonc H, Kalash Z, Stark GB, Bannasch H. Reconstruction of distal phalangeal injuries with the reverse homodigital island flap. Injury 2008; 39: 1460-3