J Reconstr Microsurg 2006; 22(7): 493-498
DOI: 10.1055/s-2006-951312
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Free Dorsal Middle Phalangeal Finger Flap

Meisei Takeishi1 , Katsuhiko Ishida1 , Kunihiro Kurihara1
  • 1Department of Plastic and Reconstructive Surgery, Jikei University School of Medicine, Tokyo, Japan
Further Information

Publication History

Accepted: April 24, 2006

Publication Date:
17 October 2006 (online)

ABSTRACT

Three patients underwent finger reconstruction using free dorsal middle phalangeal finger flaps (DMF flaps). All flaps survived. The free DMF flap relies on blood flow from the dorsal branches of the digital artery and is harvested from the skin on the dorsum of the middle phalanx. The digital artery gives rise to four dorsal branches; two in the middle and two in the proximal phalangeal regions. The flap is based on the dorsal branch of the digital artery that passes near the center of the phalanx. The characteristic feature of the free DMF flap is that the dorsal cutaneous veins are used as drainage vessels. Unlike island flaps, blood congestion does not occur after free DMF flap surgery. Sensibility of the free flap may be obtained by inclusion of the dorsal branches of the digital nerves in the flap pedicle. Loss of the digital artery at the donor site can be circumvented with venous grafting. Surgery under brachial plexus block is an advantage of this flap. The free DMF flap is a useful technique for skin and soft-tissue defects.

REFERENCES

  • 1 Buchler U, Frey H P. The dorsal middle phalangeal finger flap.  Handchirurgie. 1988;  20 239-243
  • 2 Segmuller G. Modifikation des Kutler-Lappens: Neuro-vaskulare Stieling.  Handchirurgie. 1976;  8 75-79
  • 3 Biddulph S L. The neurovascular flap in fingertip injury.  Hand. 1979;  11 59-63
  • 4 Evans D M, Martin D L. Step-advancement island flap for fingertip reconstruction.  Br J Plast Surg. 1988;  41 105-111
  • 5 Endo T, Kojima T, Hirase Y. Vascular anatomy of the finger dorsum and a new idea for coverage of the finger pulp defect that restores sensation.  J Hand Surg. 1992;  17A 927-932
  • 6 Yao J, Li J, Shen X, Chen Q, Jing S. Clinical application of free digital artery flap of the hand.  Plast Reconstr Surg. 1999;  103 980-983
  • 7 Rose E H. Local arterialized island flap coverage of difficult hand defects preserving donor digit sensibility.  Plast Reconstr Surg. 1983;  72 848-857
  • 8 Lai C S, Lin S, Chou C K, Tsai C W. Innervated reverse digital artery flap through bilateral neurorrhaphy for pulp defects.  Br J Plast Surg. 1993;  46 483-488

Meisei TakeishiM.D. 

Department of Plastic and Reconstructive Surgery, Jikei University School of Medicine

3-25-8 Nishishimbashi, Minatoku, Tokyo 105-8461, Japan

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