Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator

Abstract

Background. The hand is the most frequently injured body part. Injuries to thefingertips are among the most common hand injuries. In this article ananterograde pedicle flap based on the dorsal branches of proper digital arteryfrom the dorsum of the middle phalanx was used to reconstruct the fingertipdefect as described by Peng Wei MD in a single stage to provide a durable,sensate coverage with the least possible complications.Aim of study. To introduce and assess the result and long term follow up ofusing an anterograde pedicle flap based on the dorsal branches of proper digitalartery from the dorsum of middle phalanx.Patients and method. A total of twelve male patients were presented to usbetween November 2016 and January 2018. All of them had history of fingertipinjuries and had undergone reconstruction using anterograde pedicle flap basedon the dorsal branches of proper digital artery from the dorsum of the middlephalanx” the period of follow up ranged from one month to six months with anaverage of three months.Result. In this study 12 patients presented with fingertip defect were surgicallytreated by using an anterograde pedicle flap based on the dorsal perforator. Allthe patient had satisfactory result with good pliable contour coverage of theirinjured fingertip with no restriction of finger movements.Conclusion. The use of anterograde island flap based on the dorsal branchesof proper digital artery from the dorsum of middle phalanx is suitable forreconstruction of fingertip defects of various amputation planes, it providedgood contour texture with preservation of digital artery and nerve, it alsoprovides patient with acceptable fingertip appearance.One of the majordrawbacks of this procedure is that it requirestedious and meticulous dissectionand that donor site requires full-thickness skin graft, which leads to donor sitemorbidity and scarring.