Direct and reversed dorsal digito-metacarpal flaps: A review of 24 cases

SummaryBackground and aimThe common source for reconstruction of soft tissue defects of the fingers is either the same finger or the adjacent finger. However, when the donor areas are damaged by concomitant injuries, these options are not available. The purpose of this study was to report on reconstruction of these complex digital injuries using the dorsal digito-metacarpal flaps (DDMFs) and to evaluate the efficacy of this technique.MethodsA retrospective study was conducted with 24 patients who had their fingers reconstructed using the DDMF from April 2009 to September 2011. The patients were divided into two groups based on the flow direction of the blood supply. Among them, nine patients had their fingers reconstructed with the direct DDMFs. Fifteen patients underwent tissue reconstruction in the distal phalanx with the reversed DDMFs.ResultsAt a mean follow-up of 20 months (range, 18–24 months), the mean static two-point discrimination on the flaps was 8.3 mm (range, 7–10 mm) in the direct DDMF group and 10.4 mm (range, 9–14 mm) in the reversed DDMF group, with a significant difference (P = 0.001). The range of motion of the donor fingers was similar to that of the opposite hands. According to the Michigan Hand Outcomes Questionnaire, 11 patients were very satisfied, 10 were satisfied and three were neither satisfied nor dissatisfied with functional recovery of the reconstructed finger.ConclusionsThe DDMF is an additional option for coverage of a soft tissue defect of the finger when the commonly used local and regional flaps are not feasible.ClinicalTrials.gov IDNCT 01927003.Type of study/level of evidenceTherapeutic/IV.