The reverse flap based on two dorsal metacarpal artery for reconstruction of degloved fingertip avulsion

Objective To discuss the application of reverse flap based on two dorsal metacarpal artery for reconstruction of degloved fingertip avulsion.Methods From Jan.2005 to Mar.2008,28 cases with degloved fingertip avulsion were treated with reverse flaps based on two dorsal metacarpal artery.The defects were located distal to the distant interphalangeal joints and were 0.8-2.2 cm in length.10 defects was in the index fingers,13 in the middle fingers and 5 in the ring fingers.24 fingers were treated in an emergency surgery.4 fingers were treated due to skin necrosis.Results Epidermal necrosis happened at the distal end of flaps in 3 cases.All the other flaps survived completely.25 cases were followed up for 4-27 months with satisfactory cosmetic and functional results.The 2-points discrimination distance was 6.0-9.0 mm(average,7.6 mm).Conclusions The reverse flap based on two dorsal metacarpal artery is easily perfomed and reliable for dagloved fingertip avulsion with satisfactory results. Key words: Finger injuries; Surgical flaps