Clinical efficacy of a narrow pedicle cross-finger flap in treatment of distal fingertip degloving injuries

Objective To investigate the application of a narrow pedicle cross-finger flap in the treatment of fingertip degloving injuries. Methods Between June 2011and May 2013, 23 patients (23 fingers) suffered from fingertip degloving injuries were treated with a narrow pedicle cross-finger flap. There were 15 males (15 fingers) and 8 females (8 fingers). Defects were caused by machine crush injury in 11 cases, girdle crush injury in 7 cases and punch press injury in 5 cases. The defects were located on the index finger in 10 cases, long finger in 2 cases, ring finger in 7 cases, and little finger in 4 cases. The flaps sized 2.6 cm × 1.9 cm to 6.5 cm × 2.2 cm. After six months, according to Zhang's curative effect satisfaction score method, the efficacy of the treatment was evaluated by five aspects of skin flap healing: flap fleeing, skin flap, flap outline, flap temperature and donor site scar. Results The island flaps were survived completely in 23 patients. After followed-up for 6 to 18 months (one case was lost to follow-up) . The color and texture of the flap were the same to the surrounding normal skin, and the finger shape was satisfactory. There was no pigmentation and contraction relapse of the injured finger. The mean values of static 2-point discrimination were (6.1±1.3) mm (range, 5-8 mm) of the flap. Conclusions The narrow pedicle cross-finger flap can be used to repair the fingertip degloving injuries with the flexible flap design and reliable blood supplement. The flap survives well and the repair area is good. Therefore, it is a good method and strongly recommended for fingertip degloving injuries repair in clinics. Key words: Cross-finger flap; Degloving injury; Microsurgery