[Homodigital neurovascular island flap according to Venkataswami].

OBJECTIVE

Reliable wound coverage of the fingertip and palmar aspect of the middle finger with a sensate flap in order to restore early function.

INDICATIONS

Palmar, oblique pulp defects or amputations at the distal finger phalange with uncovered bone, tendons, and/or neurovascular structures.

CONTRAINDICATIONS

Peripheral perfusion deficiency, size of defect exceeding flap capacity, obliteration of the flap artery, i.e. contralateral finger artery.

SURGICAL TECHNIQUE

Harvesting of adipocutane, midlateral triangle based on proper digital vessel flap; distal flap transposition and primary closure of the harvesting defect, flap dimension 4-5 mm larger than defect.

POSTOPERATIVE MANAGEMENT

Finger splint for 2 weeks, followed by exercises with flap conditioning.

RESULTS

Very reliable defect coverage with 9% minor and temporary complications, all of which healed without consequences.