[Application of V-Y advancement flap pedicled with dorsal cutaneous branch of digital artery for skin defect at the same dorsal finger].

OBJECTIVE

To investigate the therapeutic effect of V-Y advancement flap pedicled with dorsal cutaneous branch of digital artery for skin defect at the same dorsal finger.

METHODS

Between January 2008 and February 2010, 15 cases of skin defect at the same dorsal finger were treated. There were 9 males and 6 females, aged 15-72 years (mean, 43 years). Defect was caused by saw machine in 6 cases, machines crush in 7 cases, and cutting nodule in 2 cases. The locations were distal dorsal finger in 2 cases, middle dorsal finger in 6 cases, and proximal dorsal finger in 7 cases. All cases complicated by exposure of tendon and bone. The size of defect ranged from 0.8 cm x 0.5 cm to 1.4 cm x 1.0 cm. The interval between injury and operation was 3-8 hours. All fingers were treated by V-Y advancement flap from the dorsal cutaneous branch of digital artery, which size was 1.2 cm x 0.8 cm-2.5 cm x 1.0 cm, and the donor site was directly sutured. Fracture reduction and Kirschner wire for internal fixation were performed in the patients with fracture; extensor tendon was repaired with 4-0 thread in the patients with tendon injury.

RESULTS

All flaps survived completely. The incisions of donor and recipient sites healed by first intention. Ten cases were followed up 6 months to 2 years after operation. The flaps had good texture, color, and appearance; 2-point discrimination of the V-Y flap was 10-12 mm. X-ray examination showed that all finger fractures healed successfully in 5 cases, with an average bone union time of 6 weeks (range, 5-8 weeks). According to the criteria for function assessment by total active motion, the results were excellent in 8 cases, good in 1, and fair in 1 with an excellent and good rate of 90%.

CONCLUSION

It is an ideal method to treat skin defect at the same dorsal finger with V-Y advancement flap pedicled with dorsal cutaneous branch of digital artery.