Reconstruction of a Composite Defect of the Distal Index Finger Using a Chimeric Reverse Flow Second Dorsal Metacarpal Artery Flap: A Case Report

2021 ◽  
Author(s):  
Koichi Yano ◽  
Yasunori Kaneshiro ◽  
Megumi Ishiko ◽  
Seungho Hyun ◽  
Hideki Sakanaka
Keyword(s):  
Distal Part ◽  
Index Finger ◽  
Skin Flap ◽  
Proximal Phalanx ◽  
Metacarpal Bone ◽  
Tissue Loss ◽  
Skin Defect ◽  
Vascular Connection ◽  
Dorsal Branch ◽  
Dorsal Metacarpal Artery

AbstractThe reconstruction for mild tissue loss at the distal part of a finger is challenging. We report about a 29-year-old man presenting with traumatic tissue loss at the distal interphalangeal (DIP) joint of the index finger, including skin, bone, and nerve. Reconstruction using two types of flaps was performed. The dorsal skin flap, nourished by the second dorsal metacarpal artery (SDMA) perforator, was elevated. The vascularized second metacarpal bone, nourished by the SDMA, was also elevated. Using the vascular connection between the DMA and the palmar digital artery (PDA), both flaps were raised to the distal part of the finger, and the pivot point was set at the dorsal proximal phalanx. After arthrodesis of the DIP joint with the vascularized second metacarpal bone, the digital nerve was repaired using the cutaneous nerve in the skin flap, and the skin defect was covered using the perforator flap. The postoperative course, including flap survival and bone union, was uneventful. A good indication for the reconstruction of the distal part of a finger with this technique is when the defect sizes of the skin and bone differ and the vascular connection between the SDMA and dorsal branch of PDA is not injured.

The Dorsal Flap of the First Web

2003 ◽  
Vol 28 (2) ◽  
pp. 121-124 ◽  
Author(s):  
A. PAGLIEI ◽  
L. ROCCHI ◽  
A. TULLI
Keyword(s):  
Soft Tissue ◽  
Index Finger ◽  
Tissue Loss ◽  
Space Region ◽  
Soft Tissue Defects ◽  
Dorsal Branch ◽  
Web Space ◽  
Distally Based ◽  
Soft Tissue Loss ◽  
Tissue Defects

In the first web space region, there are communications between the dorsal arteries which arise from the dorsal branch of the radial artery and the digital arteries of the thumb and the index finger. These allow a distally based flap to be raised in the first dorsal intermetacarpal area. This flap has been used in 15 cases of soft-tissue loss from the thumb and index finger. The donor sites were closed primarily in all but two patients. There were no complications, and the results show that this flap is useful for soft-tissue defects on the tip and the palmar and dorsal surfaces of the thumb. Moreover, it may be used as a “cross-finger” flap.

scholarly journals Circumferential skin defect - Ilizarov technique in plastic surgery

2004 ◽  
Vol 37 (01) ◽  
pp. 55-59
Author(s):  
Vrisha Madhuri ◽  
R Shankar Kurpad ◽  
Manasseh Nithyananth ◽  
S Thilak Jepegnanam ◽  
V. T.K. Titus ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Distal Part ◽  
Open Fracture ◽  
Tissue Loss ◽  
Skin Defect ◽  
Ilizarov Technique ◽  
Limb Reconstruction ◽  
Skin Staples ◽  
Soft Tissue Loss

ABSTRACTA young man had an open fracture of the tibia with bone and soft tissue loss in the distal part of the left leg following a crush injury. The circumferential skin defect was successfully treated with controlled lengthening of the distal skin by the Ilizarov technique using nylon wires and skin staples to apply traction. This was combined with limb reconstruction done simultaneously using orthofix external fixator. This case report highlights the use of an orthopaedic technique to provide skin cover in distal leg.

Compression of the Distal Ulnar Nerve with Clawing of the Index Finger

HAND ◽  
1982 ◽  
Vol os-14 (1) ◽  
pp. 38-40 ◽  
Author(s):  
N. P. Packer ◽  
G. R. Fisk
Keyword(s):  
Ulnar Nerve ◽  
Distal Part ◽  
Similar Case ◽  
Index Finger ◽  
Motor Branch

A compression lesion of the distal part of the terminal motor branch of the ulnar nerve is presented. One similar case has been previously described (McDowell, 1977) but some unusual features are recorded here. The reported clinical varieties of lesions of the ulnar nerve in the hand are listed (Table 1).

Dorsal metacarpal artery perforator-based propeller flap for complex defect of the dorsal aspect in the index finger

2009 ◽  
Vol 34 (6) ◽  
pp. 807-809 ◽  
Author(s):  
Bruno Battiston ◽  
Stefano Artiaco ◽  
Andrea Antonini ◽  
Valentina Camilleri ◽  
Pierluigi Tos
Keyword(s):  
Index Finger ◽  
Complex Defect ◽  
Dorsal Aspect ◽  
Propeller Flap ◽  
Dorsal Metacarpal Artery ◽  
Artery Perforator

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.

Using KISS Flaps in a Chest Wall Reconstruction After Mastectomy for Locally Advanced Breast Cancer: A New Technique

2019 ◽  
Vol 27 (1) ◽  
pp. 5-10
Author(s):  
Jia Song ◽  
Yong Han ◽  
Jian Liu ◽  
Kai Cheng ◽  
Qiang Gao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Primary Closure ◽  
Locally Advanced Breast Cancer ◽  
Skin Flap ◽  
Donor Site ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Advanced Breast ◽  
Skin Defect

This study described a technique for the reconstruction of large lateral thoracic defects after local advanced breast cancer resection that allows for complete cover of the defect and primary closure of the donor site. The authors performed reconstruction using the newly designed KISS flap in 2 women for coverage of their large skin defect (15 × 13 cm each) following mastectomies with extensive tissue resection. The KISS flap consisting of 2 skin islands (marked Flap A and Flap B; 15 × 6 cm each) was designed and transferred to the thoracic defect through the subcutaneous tunnel, and based on the same vessel. The flap covered properly without causing excessive tension and allowed primary closure of chest wound and donor defect. The security it brings is comparable with that of classical radical mastectomy, and its success rate is similar to that of single skin flap transplantation. Compared with the conventional pedicled latissimus-dorsi-musculocutaneous flap, we believe that the donor zone tension decreases, wherein the KISS flaps can reduce the incidence of incision dehiscence and nonhealing complications to some extent. The study reported good results from this technique and discussed the techniques that referenced previous reports.

scholarly journals Observation on the Effect of Local Flap Transfer and Sclera Transplantation in Repairing Skin Defect after Eyelid Tumor Operation

2020 ◽  
Vol 4 (1) ◽  
pp. 28-31
Author(s):  
Ying-Hui Ma ◽  
Gang Liu ◽  
Jie Yang
Keyword(s):  
Skin Flap ◽  
Tumor Resection ◽  
Local Flap ◽  
Control Group ◽  
Skin Defect ◽  
Local Skin ◽  
Eyelid Tumor ◽  
Flap Transfer ◽  
Wide Range ◽  
Experimental Group

Introduction: Eyelid tumor refers to the primary eyelid skin and accessory tumors, which not only affects the appearance and vision, and even local infiltration and distant metastasis, thereby threatening life. Surgical resection is the most important and effective treatment, but tumor resection often leads to a wide range of eyelid defects, significantly affecting the shape and function of the eyelid. Therefore, the eyelid defect must be repaired after resection to achieve the purpose of aesthetic appearance and protection of the eyeball. The objective of the study was to analyze the clinical results of local flap transfer and scleral transplantation in repairing skin defect after eyelid tumor operation. Methods: Forty patients with postoperative skin defects of eyelid tumors admitted from December 2008 to December 2018 were taken for analysis and divided into two groups, 20 cases in each group. The control group underwent autologous lip mucous membrane transfer and nearby skin flap, while the experimental group received local skin flap rotation and scleral allograft repair. The clinical effect of repair of the two groups were compared. Results: In the experimental group, the effect of clinical repairs were better, the difference of height of palpebralfissure and the length of palpebral fissure were compared with the control group, which showed statistical significance favoring the experimental group. Conclusion: Local flap transfer and scleral transplantation has better clinical outcome to repair the skin defect after operation of eyelid tumor.

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