Sage Journals: Discover world-class research

Abstract

We report our experience with 42 bipedicle strap flaps in 42 fingers of 37 patients for the reconstruction of long longitudinal dorsal finger defects. Twelve cases were compound lesions with tendon lacerations. All flaps healed without infection, congestion or necrosis. At follow-up, mean total active interphalangeal joint mobility was 150° and 108° in patients without and with tendon lacerations, respectively. The median scores of the short version of the Disability of Arm, Shoulder and Hand questionnaire were 5 and 7, respectively. Patients were able to return to work or to their daily activities after a mean of 6 weeks. The patients were satisfied with the appearance in 34 of the 42 flaps. We conclude that the flap is a useful option for reconstructing dorsal digital lesions. It has a texture similar to the normal dorsal digital skin, and it is easy to perform without needing microsurgery.

Level of evidence: IV

Keywords

Dorsal soft tissue defect fingers;soft tissue coverage bipedicle strap flap

Get full access to this article

View all access options for this article.

References

Bas

Kleinert

. Anatomic variations in sensory innervation of the hand and digits. J Hand Surg Am. 1999, 24: 1171–84.

Braga-Silva J, Kuyven CR, Fallopa F, et al. An anatomical study of the dorsal cutaneous branches of the digital arteries. J Hand Surg Br. 2002, 27: 577-579.

De Resende

Mattar Junior

Cho

, et al.Anatomic study of the dorsal arterial system of the hand. Rev Hosp Clin Fac Med S Paulo. 2004, 59: 71–6.

Endo

Kojima

Hirase

. Vascular anatomy of the finger dorsum and new idea for coverage of the finger pulp defect that restores sensation. J Hand Surg Am. 1992, 17: 927–32.

Fujiwara

Ito

Fukamizu

. Bipedicle flap reconstruction for complex longitudinal dorsal tissue defects of the digits. Hand Surg. 2007, 12: 191–7.

Lassner F, Becker M, Berger A, et al. Sensory recon-struction of the fingertip using the bilaterally innervated sensory cross-finger flap. Plast Reconstr Surg. 2002, 109: 988--993.

Levame

Otero

Berdugo

. Vascularisation artérielle des téguments de la face dorsale de la main et des doigts. Ann Chir Plast. 1967, 12: 316.

Snow

. A method for reconstruction of the central slip of the extensor tendon of a finger. Plast Reconstr Surg. 1976, 57: 455–9.

Strauch

De Moura

. Arterial system of the fingers. J Hand Surg Am. 1990, 15: 148–54.

10.

Takeishi M, Shinoda A, Sugiyama A, et al. Innervated reverse dorsal digital island flap for fingertip reconstruction. J Hand Surg Am. 2006, 31: 1094--1099.

11.

Tang

Giddins

. Why and how to report surgeons' levels of expertise. J Hand Surg Eur. 2016, 41: 365–6.

12.

Toros

Özaksar

Sügün

, et al.Unipedicled laterodigital transposition flap for covering dorsal longitudinal skin defects in multi-digit injuries. J Hand Surg Eur. 2011, 36: 179–84.

13.

Trovato MJ, Brooks D, Buntic RF, et al. Simultaneous coverage of two separate dorsal digital defects with a syndactylizing venous free flap. Microsurgery. 2008, 28: 248--251.

14.

Yii

Elliot

. Bipedicle strap flaps in reconstruction of longitudinal dorsal skin defect of the digits. Plast Reconstr Surg. 1999, 103: 1205–11.

15.

Yu GR, Yuan F, Chang SM, et al. Microsurgical second dorsal metacarpal artery cutaneous and tenocutaneous flap for distal finger reconstruction: anatomic study and clinical application. Microsurgery. 2005, 25: 30--35.

Bipedicle strap flaps for reconstruction of longitudinal dorsal finger defects: a review of 42 cases

Abstract

Keywords

Get full access to this article

References