Background: Fingertip injuries are very common. Reconstruction
of extensive distal phalangeal defects with exposure
of tendon, bone, or joint can be particularly a difficult problem.
Options are local, regional and free flaps. SSG on bone and
tendon is unsuccessful and nondurable. The primary goals of
digital reconstruction are to preserve digital length and maintain
full mobility of the digit with providing adequate protective
cover of the deeper vital structures with soft tissue and skin
of good quality. Homodigital artery island flap has been found
to be very useful and is commonly used for the recon‌struction
of fingertip amputations.
Patients and Methods: We used the reversed homodigital
artery island flap to reconstruct fingertip injuries in 8 patients
at Minia University Hospital and private sector in the period
between January to December 2017. We retrospectively
analyzed patients for: Age, sex, mechanism of injury, location
of defect, flap survival, sensory recovery and donor site
coverage.
Results: Five patients were males and 3 females. Age
from 18 to 42 years mean (27.3 years). Six patients had
complete flap survival and two patients suffered venous
congestion that resolved completely by conservative measures.
Donor site closure was directly closed in all cases. Near
normal sensory recovery was noted.
Conclusion: The reverse homodigital island flap is a safe
method for distal phalangeal reconstruction offering multiple
advantages over other local, regional and free flaps with an
almost negligible donor site defect. Venous congestion and
inability to reconstruct proximal finger defects are drawbacks