[Different mini skin flaps in repairing finger soft tissue with bone defect]

Area of Science:

• Plastic Surgery
• Hand Surgery
• Reconstructive Surgery

Background:

• Finger soft tissue and bone defects pose significant reconstructive challenges.
• Effective surgical techniques are crucial for restoring finger function and appearance.

Purpose of the Study:

• To compare the surgical methods and clinical outcomes of three distinct mini skin flap transplantation techniques.
• To evaluate the efficacy of these flaps in repairing finger soft tissue and bone defects.

Main Methods:

• A cohort of 33 patients with finger defects underwent reconstruction using one of three mini skin flap types.
• Techniques included retrograde dorsal metacarpal artery perforator fascia flap, free foot artery descending branch wrist skin flap, and free second toe phalangeal compound flap.
• Outcomes assessed included flap survival, complications, and finger function using Dargan criteria.

Main Results:

• All transplanted flaps survived successfully with no deep infections at recipient sites.
• Minor donor site complications (necrosis) occurred in two patients but healed with conservative management.
• Functional assessment showed excellent results in 18 patients, moderate in 14, and good in 1, with restored sensation and appearance.

Conclusions:

• All three mini skin flap techniques are effective for finger soft tissue and bone defect repair.
• The retrograde dorsal metacarpal artery perforator fascia flap is advantageous due to its simplicity, safety, and high survival rate without vessel anastomosis.
• Free ulnar artery flaps and second toe flaps offer distinct benefits for specific reconstructive needs, including minimal scarring and optimal shape/function restoration.