Optimizing Fingertip Reconstruction: A Comparative Analysis of Reverse Homodigital Island and Digital Artery...

Area of Science:

• Hand surgery
• Microsurgery
• Reconstructive surgery

Background:

• Fingertip amputations are common hand traumas requiring soft tissue reconstruction.
• Reverse homodigital island (RHI) and digital artery perforator (DAP) flaps are common reconstruction techniques.
• Limited direct comparisons exist for RHI vs. DAP flap clinical outcomes.

Purpose of the Study:

• To compare the clinical outcomes of RHI and DAP flaps for fingertip reconstruction.
• To evaluate flap survival, operative time, hospital stay, functional recovery, and complications.
• To determine the preferable technique based on functional and aesthetic results.

Main Methods:

• Retrospective analysis of 39 patients with fingertip injuries undergoing RHI (n=20) or DAP (n=19) flap reconstruction.
• Exclusion of thumb injuries, multiple finger injuries, and cases with insufficient follow-up.
• Assessment of outcomes including flap survival, operative time, hospital stay, functional recovery, and complications.

Main Results:

• Both RHI and DAP flaps showed high survival rates with no major necrosis.
• DAP flap procedures were significantly shorter (68 min vs. 101 min for RHI) with shorter hospital stays (13 days vs. 18 days for RHI).
• DAP group had a lower secondary procedure rate (21.1% vs. 70% for RHI) but more nail deformities (47.4%).

Conclusions:

• The DAP flap is preferable for functional reconstruction due to shorter operative time, faster recovery, and fewer secondary procedures.
• The RHI flap may offer superior aesthetic outcomes, though it involves a longer treatment period.
• Both techniques provide high flap survival and good functional recovery for fingertip injuries.