The Second Dorsal Metacarpal Artery Neurovascular Island Flap

1989 ◽  
Vol 14 (4) ◽  
pp. 434-440
Author(s):  
M. J. EARLEY
Keyword(s):  
Donor Site ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Island Flap ◽  
Arterial Supply ◽  
Flap Necrosis ◽  
Local Skin ◽  
Skin Defects ◽  
Dorsal Metacarpal Artery

Eleven patients have had second dorsal metacarpal sensate island flaps used to cover local skin defects in the hand. The arterial supply is reliable but if the flap is extended beyond the proximal interphalangeal joint, distal flap necrosis or donor site difficulties may occur. Possible applications for this flap are demonstrated and some untried variations to increase its range are suggested. Its main use appears to be in the release of first web contractures and for resurfacing radio-palmar and thumb defects.

The First Dorsal Metacarpal Artery Neurovascular Island Flap

1988 ◽  
Vol 13 (2) ◽  
pp. 136-145
Author(s):  
J. O. SMALL ◽  
M. D. BRENNEN
Keyword(s):  
Index Finger ◽  
Donor Site ◽  
Island Flap ◽  
Neurovascular Flap ◽  
Dorsal Metacarpal Artery ◽  
First Dorsal Metacarpal Artery

A first dorsal metacarpal artery island flap from the index finger was used in 20 cases for reconstruction of defects in the hand. In six cases it was used as a neurovascular flap for sensory resurfacing of the thumb and in five cases for release of a contracted first web. One flap underwent necrosis and there was a complication in one donor site.

Extensor Indicis Opposition Transfer in The Ulnar and Median Palsied Thumb in Leprosy

1996 ◽  
Vol 21 (5) ◽  
pp. 617-621 ◽  
Author(s):  
R. MEHTA ◽  
G. N. MALAVIYA ◽  
S. HUSAIN
Keyword(s):  
Index Finger ◽  
Donor Site ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Pollicis Longus ◽  
Extensor Pollicis Longus ◽  
Extensor Indicis Proprius ◽  
Leprosy Patients ◽  
Significant Deficit

Twenty seven opponensplasties for ulnar and median paralysis in 25 leprosy patients were performed using extensor indicis proprius. An additional transfer of the radial half of flexor pollicis longus to extensor pollicis longus was done to stabilize the metacarpophalangeal joint of the thumb. The biomechanical aspects of extensor indicis proprius tendon transfer were studied and results evaluated using various anatomical and functional parameters. Extensor indicis proprius provides adequate strength to position the thumb. However, sometimes it does not reach its new insertion. There is no significant deficit at the donor site but in a few cases the index finger may lose its capability for independent extension and sometimes a proximal interphalangeal joint contracture may develop.

Maximal advancement of homodigital neurovascular island flaps

2019 ◽  
Vol 44 (10) ◽  
pp. 1008-1012 ◽  
Author(s):  
Jin Xi Lim ◽  
Alphonsus Khin Sze Chong ◽  
Sandeep Jacob Sebastin
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Island Flap ◽  
Digital Artery ◽  
Full Extension ◽  
Finger Length

We investigated the maximal advancement of the homodigital neurovascular island flap with the digit in full extension and its correlation to the digital length. In 32 adult cadaveric digits, flaps measuring 1 × 1 cm were sequentially elevated to different dissection points. Dissection of the flap to the proximal interphalangeal joint crease, palmo-digital crease, division of adjacent digital artery and the superficial arch resulted in flap advancement of 8, 12, 15 and 18 mm, respectively. The degree of advancement correlated to the length of the finger and was approximately 19% of the finger length. We conclude that dissection of a homodigital antegrade neurovascular island flap to the proximal interphalangeal joint, palmo-digital crease, after ligation of adjacent digital artery and the superficial arch allows progressively more advancement. The advancement obtained by flap dissection to the palmo-digital crease was about 19% of the finger length.

Optimizing donor site outcomes after microsurgical proximal interphalangeal joint transfer using the bone-peg technique

2015 ◽  
Vol 68 (6) ◽  
pp. 874-876 ◽  
Author(s):  
Dariush Nikkhah ◽  
Georgios Orfaniotis ◽  
Fabio Nicoli ◽  
Pedro Ciudad ◽  
Hung Chi Chen
Keyword(s):  
Donor Site ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint

Ulnar Parametacarpal Flap for Small Finger Avulsion Injury

2021 ◽  
Vol 26 (03) ◽  
pp. 477-480
Author(s):  
Shinsuke Takeda ◽  
Katsuyuki Iwatsuki ◽  
So Mitsuya ◽  
Miku Mitsuya ◽  
Yutaro Kuwahara ◽  
...  
Keyword(s):  
Proximal Phalanx ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Island Flap ◽  
Skin Defect ◽  
Avulsion Injury ◽  
Propeller Flap ◽  
Alternative Method ◽  
Difficult Cases

In difficult cases of replantation following small finger avulsion injury, in which amputation occurs at the proximal interphalangeal joint, the ulnar parametacarpal island flap, rotated 180° (propeller flap), can be used as an alternative method for covering a skin defect of the proximal phalanx. This flap can prevent metacarpophalangeal joint dysfunction and additional finger shortening. We propose the use of an ulnar parametacarpal flap for this purpose and report the outcomes of two successful cases treated with this method and followed up for 12 months.

scholarly journals Predictors of Proximal Interphalangeal Joint Flexion Contracture After Homodigital Island Flap

2015 ◽  
Vol 40 (11) ◽  
pp. 2155-2159 ◽  
Author(s):  
Akito Nakanishi ◽  
Shohei Omokawa ◽  
Akio Iida ◽  
Daisuke Kaji ◽  
Yasuhito Tanaka
Keyword(s):  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Island Flap ◽  
Joint Flexion

Flap Related Complications Requiring Secondary Surgery in a Series of 851 Local Flaps Used for Fingertip Reconstruction

2019 ◽  
Vol 24 (01) ◽  
pp. 24-29 ◽  
Author(s):  
T. Karjalainen ◽  
S.J. Sebastin ◽  
K.G. Chee ◽  
Y.P. Peng ◽  
A.K.S. Chong
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Advancement Flap ◽  
Flexion Contracture ◽  
Island Flap ◽  
Local Flaps ◽  
Flap Necrosis ◽  
Secondary Surgery ◽  
Partial Necrosis ◽  
Fingertip Reconstruction

Background: Local flaps are widely used to cover fingertip defects. Errors in design or technical execution of the flap may lead to morbidity and additional surgical procedure. The purpose of this study was to review flap related complications requiring unplanned secondary surgery to characterize preventable issues. Methods: 851 local flaps were used to reconstruct fingertip defects during a 9-year period. Patients requiring unplanned secondary surgery to address flap related complications were subjected to analysis. Results: 31 of 851 flaps (3.6%) required unplanned secondary surgery because of flap related complications. The most reliable flap was VY advancement flap with only one (0.3%) re-operation. The reverse vascular island flap, cross finger flap, and neurovascular island flap were associated with the comparable number of complications (8.0%; 6.3%; and 3.8% respectively). Total or partial necrosis was the cause for re-operation in 6 patients (0.7%). The typical reason for secondary surgery was inadequate soft tissue cover of the tip with homodigital neurovascular island flap and flexion contracture with reverse vascular island flap. Cross finger flaps were revised because of poor graft take at the donor site, bulky flap or flap necrosis. Conclusions: Local flaps are reliable operations to cover fingertip defects. Each flap has potential pitfalls, which may be avoided if the surgeon is aware of them.

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