Efficacy of two reverse pedicle flaps for repairing soft tissue defects of the finger

Objective To observe the effect of two reverse pedicle flap repaired soft tissue defect of the finger. Methods From April, 2011 to March, 2015, 46 patients were randomly divided into two groups. Twenty-eight cases were performed by dorsal metacarpal artery flaps with cutaneous branches as pedicle and the 18 cases were performed by reverse the proper palmar digital artery dorsal branches island flap. The complication, survival rate, hand function and appearance were analyzed. Results The dorsal metacarpal artery flaps with cutaneous branches as pedicle and reverse the proper palmar digital artery dorsal branches island flap were an average follow-up of 18 and 15 months, all flaps survived. For fingertip defects, 8 cases were repaired with as pedicle as the dorsal metacarpal artery flaps with cutaneous branches as pedicle while 16 cases were repaired with reverse the proper palmar digital artery dorsal branches island flap. Among them, complication included 2 cases of early venous congestion and 2 cases of superficial skin necrosis. One case of reverse the digital artery dorsal branches island flap blistered; the flap sensibility was good recovery. The two-point discrimination testing of dorsal metacarpal artery flaps with cutaneous branches as pedicle was from 6.0 to 9.0 mm (average of 7.1 ± 0.5 mm); the two-point discrimination testing of dorsal metacarpal artery flaps with cutaneous branches as pedicle was from 4.0 to 7.0 mm(average of 5.2 ± 0.4 mm), but there were differences in two-point discrimination and there was statistically significant(P < 0.05). There was no significant difference between the two groups each finger interphalangeal joint activity compared with the healthy side. The study found that 10 cases of dorsal metacarpal artery flaps appearance was 5 mm higher than normal skin and 1 patient of reverse the digital artery dorsal branches island flap appearance was 5 mm higher than normal skin, the difference was statistically significant (P < 0.05), the latter was better than the former, especially repaired fingertip defect. Conclusion Dorsal metacarpal artery flaps with cutaneous branches as pedicle and reverse the proper palmar digital artery dorsal branches island flap were safe and reliable, it is the ideal flap finger defects. For finger fingertip defect repaired reverse the proper palmar digital artery dorsal branches island flap is superior dorsal metacarpal artery flaps with cutaneous branches as pedicle. Key words: Fingers; Surgical flap; Dorsal metacarpal artery; Proper palmardigital artery