Nerve Sparing Antegrade Homodigital Island Flap

Elsherbeny, Khaled M; Hweidi, Ahmed S; Gad, Ahmed M

doi:10.21608/ejprs.2023.291385

Nerve Sparing Antegrade Homodigital Island Flap

Document Type : Research article

Authors

The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University

10.21608/ejprs.2023.291385

Abstract

Background: Fingertip reconstruction requires stable,
sensate, and painless padding. Digital defects proximal to the
tip around distal interphalangeal joint or dorsal raw areas
preclude these objectives except for preserving the sensation
to the fingertip. Antegrade Homodigital island flap accomplishes
these objectives for fingertip defect coverage.
Objective: In this case series, we modify this flap to cover
different defects proximal to the fingertip while sparing the
digital nerve to preserve fingertip sensation.
Material and Methods: Between March 2019 till June
2022 Fourteen patients (fifteen finger) with deformed distal
phalanges, contracted distal interphalangeal joint, or defects
sparing the finger tips were treated with a nerve sparing
antegrade homodigital island flap. The mean age was 27±17
years old. The etiologies were post-traumatic, post-burn or
firearm injury. Follow-up period ranged from 4-18 months.
Results: All flaps survived with delayed wound healing
in two flaps and proximal interphalangeal joint 15 degrees'
extension lag in one patient. Fingertip sensation was preserved
in all patients with mean 2 point-discrimination (2PD) test
3±1mm. We evaluated patient satisfaction regarding cosmetic
and functional outcomes.
Conclusion: Nerve sparing antegrade homodigital island
flap is considered a reasonable choice for covering finger
defects proximal to the fingertips. It provides durable, robust,
and aesthetically accepted coverage.

Keywords

Main Subjects

Hand and Upper Limb Surgery'

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