Arch Hand Microsurg.  2019 Dec;24(4):376-380. 10.12790/ahm.2019.24.4.376.

Reconstruction of the Fingertip Defect with a Free Radial Artery Superficial Palmar Branch Flap and Iliac Bone Graft

• Lee J
• Park HS
• Whang JI

• KMID: 2464474
• DOI: http://doi.org/10.12790/ahm.2019.24.4.376

Abstract

Fingertip injury occurs due to various causes. Trauma is the most common cause, and most cases are accompanied by bone defects as well as skin and soft tissue defects. When soft tissue and bone defects occur at the fingertip, it is necessary not only to cover the soft tissue defects but also to reconstruct the bones to ensure stability of the fingertip. The authors performed a free radial artery superficial palmar branch flap and iliac bone grafts in patients with soft tissue and bone defects at the fingertip, with satisfactory results. A literature review was also conducted.

Keyword

Free flap; Graft; Injury

MeSH Terms

Free Tissue Flaps
Humans
Radial Artery*
Skin
Transplants*

Figure

• 

  Fig. 1 A 54-year-old male with skin, soft tissue and bone defects on the left 2nd finger caused by a crushing injury. (A, B) Preoperative photo. (C) Preoperative X-ray. Most of the distal phalangeal bone of the left 2nd finger was lost (informed consent was taken).

• 

  Fig. 2 The day after the first operation, a free radial artery superficial palmar branch flap was performed. (A) Flap elevation. (B) Flap insetting.

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  Fig. 3 One month after flap surgery. (A, B) The skin and soft tissue defects were covered with a free radial artery superficial palmar branch flap. (C) Temporary fixation with K-wire.

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  Fig. 4 Six weeks after flap surgery, an autogenous iliac bone graft was done.

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  Fig. 5 Eight months after free radial artery superficial palmar branch flap coverage. (A, B) Postoperative photo. There were no functional problems such as scar contracture or skin atrophy. (C) Six months after the autogenous iliac bone graft, a bone union was done.

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