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CC BY-NC 4.0 · Arch Plast Surg 2020; 47(05): 451-459
DOI: 10.5999/aps.2020.00269
Original Article

Arterial or venous free flaps for volar tissue defects of the proximal interphalangeal joint: A comparison of surgical outcomes

Min Suk Choi 
Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
,
Si Young Roh 
Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
,
Sung Hoon Koh 
Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
,
Jin Soo Kim 
Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
,
Dong Chul Lee 
Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
,
Kyung Jin Lee 
Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
,
Min Ki Hong 
Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
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Background For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint.

Methods This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects >6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients’ age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups.

Results Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P=0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant.

Conclusions The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.

Keywords - Free tissue transfer flaps - Interphalangeal joint of finger - Reconstructive surgical procedure

This article was presented at the 36th Korean Society for Surgery of the Hand Annual International Meeting on November 2–4, 2018, in Seoul, Korea.




Publication History

Received: 21 February 2020

Accepted: 22 July 2020

Article published online:
22 March 2022

© 2020. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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