Sensory Reconstruction of Finger Pulp Defect Using a Dorsal Digital Island Flap

Sensory Reconstruction of Finger Pulp Defect Using a Dorsal Digital Island Flap

Sensory reconstruction of the finger pulp is a challenging problem. This article reports repair of the finger pulp defect using the dorsal digital island flap. Both dorsal branches of the proper digital nerves (PDNs) were used for maximal sensory restoration.

From February 2008 to May 2009, the flap harvested from the dorsum of the middle phalanx of the same finger was used in 12 fingers in 12 patients. The flaps ranged in size from 2.0 × 2.0 cm to 2.8 × 2.2 cm. The mean pedicle length was 1.2 cm. Neurorrhaphy between the dorsal branches of the PDN and PDN was performed in both sides in all cases. Sensibility of the reconstructed finger pulp was evaluated by static 2-point discrimination (2PD) and Semmes-Weinstein monofilament test. The range of motion of the donor fingers was measured. The data were compared to those of the opposite sides.

Inclusion Criteria:

1. a finger pulp defect > 1.5 cm in length
2. necessity to preserve finger length
3. patients younger than 60 years .

Exclusion Criteria:

1. injury to the dorsum of the middle phalanx of the reconstructed finger that precluded its use as donor site
2. injury to the course of the vascular pedicle or opposite PDA
3. defects < 1.5 cm in length.