We present 12 cases in which palmaris longus tendocutaneous arterialized venous free flaps were used for the reconstruction of the collateral ligament in compound defects of digits. There were nine cases involving the interphalangeal joint of the fingers and three of the interphalangeal joints of the thumb. The venous flaps survived completely in 10 of the 12 cases. In 11 cases, there were excellent functional results for joint stability, pain, total active motion and pinch power. In all 12 cases, a pain-free joint with excellent stability was achieved after surgery. The palmaris longus tendocutaneous arterialized venous free flap is a good option for reconstruction of composite defects of the collateral ligament of the interphalangeal joint.
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