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CLASSIFICATION OF FINGER FLAPS AND ITS USE IN EMERGENCY TREATMENT FORFINGER INJURIES

Objective To choose the homodigital and the heterodigital flaps in the reconstruction of the distal finger injuries and to summarize the treatment results obtained in the clinical practice. Methods From August 2001 to June 2005, 112 injured fingers in 108 patients (68 males, 40 females; aged 16-63 years) were surgically treated. The injuries were due to remotion, crushing or avulsion, and they underwent operations 2 hours after the injuries. Nine kinds of flaps were taken from the dorsal or volar aspect of the injured fingers to cover the defects of the distal fingers. The flaps were divided into two kinds: ① The flaps were nourished by the main digital arterial branches, including the V-Y island flap based on the digital neurovascular bundles, the reversed digital artery flap, the modified Moberg flap, and the twins flaps based on the digital general neurovascular bundles (flaps ranging in area from 1.5 cm × 2.0 cm); and ② The flaps were nourished by the collateral digital arterial branches, including the dorsoulnar arterial retrograde flap of the thumb(flaps ranging in area from 1.5 cm×1.5 cm to 3.0 cm×2.5 cm) andthe reverse flap based on the dorsal branches of the digital artery (flaps ranging in area from 1.7 cm×1.0 cm to 4.5 cm×3.0 cm), the volar flap based on the transverse palmar branch of the digital artery (flaps ranging in area from 2.0 cm×1.0 cm to 2.5 cm×2.0 cm), and the island flap from the dorsum ofthe index finger and the digital local flaps. Results The follow-up for 2 weeks to 8 months revealed that all the flaps survived with an exception of flap necrosis in 3 patients and superficial necrosis in 3 patients. The sensation reached almost normal levels in the flaps based on collateral digital arteries and the twopoint discrimination was between 5 mm and 10 mm in the flaps based on the arterial branches. The finger motion ability was good and the finger appearance was satisfactory. Conclusion The choice of the above-mentioned skin flaps can repair the soft tissue defects of the distal parts of the fingers, which can have a satisfactory restoration contour.