J Reconstr Microsurg 2009; 25(3): 171-179
DOI: 10.1055/s-0028-1103506
© Thieme Medical Publishers

Reverse Midpalmar Island Flap Transfer for Fingertip Reconstruction

Shohei Omokawa1 , Ryotaro Fujitani1 , Yoshihiro Dohi1 , Yasuhito Tanaka2 , Hiroshi Yajima2
  • 1Orthopedics, Ishinkai-Yao Hospital, Nara Prefecture, Japan
  • 2Orthopedics, Nara Medical University, Nara Prefecture, Japan
Further Information

Publication History

Publication Date:
26 November 2008 (online)


Significant soft tissue defects of the fingertip with exposure of tendon or bone represent a challenging problem when homodigital or heterodigital artery island flaps are not available. In an attempt to resolve this problem, 15 patients with fingertip injuries involving palmar skin defects or amputation were treated with a vascularized flap transfer from the midpalmar area. A 2.5 × 1.5 to 4.5 × 2 cm flap from the radial or distal aspect of the midpalm, pedicled on the terminal branch of the superficial palmar arch or common/proper palmar digital artery and vein, was transferred in a retrograde fashion to cover the skin and soft tissue defects of the finger. All the flaps survived without complications. Moving two-point discrimination in the flap averaged 6 mm in patients who underwent sensory flap transfer. We concluded that vascularized skin flaps from the radial or distal aspects of the midpalm offer a good alternative option for the reconstruction of fingertip palmar skin and soft tissue defects.


Shohei Omokawa, M.D. 

Ishinkai-Yao Hospital - Orthopedics

1-41 Numa Osaka 581-0036 Japan

Email: omokawa@gaia.eonet.ne.jp