ABSTRACT
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.
KEYWORDS
Fingertip - flap - midpalm
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Shohei OmokawaM.D.
Ishinkai-Yao Hospital - Orthopedics
1-41 Numa Osaka 581-0036 Japan
Email: omokawa@gaia.eonet.ne.jp
