Homodigital Reverse Pedicled Island Flap in Soft Tissue Reconstruction of The Finger Tip

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Journal of the Korean Society for Surgery of the Hand 1996;1(1):52-58.
Published online January 1, 1996.

Duke Whan Chung,Chung Soo Han,Eun Whan Bae,Chang Hyun Cho

수지 말단부 연부조직 결손에 시행한 동측 역행성 유경피판술

정덕환,한정수,배은환,조창현

Abstract

The finger tip is, in the industrial working or ordinary life, very vulnerable to crushing wounds, causing the phalangeal defect or open fracture. The shortening of exposed phalangeal tip is prerequisite to the primary closure when finger tips, especially palmar thick skin and their soft tissue are fatally deficient. The distant flap or pedicle flap is available with no bone shortening, but there are several problems depends on each procedures. More convenient treatment is found out with the primary closure of defected parts, by the use of digital artery, by backward turn of skin in the proximal portion, in the direction of distal portion. Authors performs homodigital reverse pedicled island flap with encourageable results in eight patients who had injury of finger tip with large amount of soft tissue loss with or without bone loss since July 1994. Mean age of the patient was 29 years old. Three cases in index finger, two in middle finger, two in ring finger, and one in little finger were operated. Six cases were cured by primary closure with the good result, one case had slow progression of congestion in flap, and one case had flap necrosis which needed split thickness skin graft after the cultivation of granulation tissue after removal of necrotic tissue. This method is comparatively simple and convenient in emergency room basis, and is thought to be one of the best methods in the treatment of crushing injuried patient in the finger tips who had profound loss of finger pulp.

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