The Homodigital Island Flap: A Good Result of Fingertip Injuries Reconstruction on Single Center Hospital

Aims: To report a case of fingertip injuries reconstructed with homodigital island flap technique.

Case Description: A 49-year-old man presented with a phalangeal defect of the 2nd finger of the right hand. There were skin and soft tissue losses without bone and tendon exposed. The operation was performed under general anesthesia and with a tourniquet applied to the upper arm. The flap was marked up lateropalmarly on the proximal basal phalanx at the radial side. After the tourniquet had been released and complete hemostasis carried out, the flap was rotated into the defect and fixed. The donor site defect was covered with a full-thickness skin graft. During the follow-up, the island flap showed a good outcome. The skin graft also healed well. Sensibility and vascularization were good.

Discussion: Treatments for fingertip injuries available cover a broad range of techniques with no single recommended reference standard for treatment. Island flaps are axial pattern flaps that maintain blood flow through a specific vascular pedicle. Island flaps may be considered the ideal choice for soft tissue coverage and reconstruction of fingertip defects when the preservation of length and maximal function are desired, and critical structures are exposed or injured. The advantage of the homodigital island flap is that it is a local flap technique with a reliable blood supply and provides stable coverage with an inconspicuous donor site. Besides, this technique does not need postoperative immobilization of other fingers and has a slight aesthetic removal defect. Using this technique can cause irritation to digital nerve for a few weeks, but this usually resolves completely.

Conclusions: Homodigital island flap is a useful and safe reconstruction option for fingertip injuries, considering its advantages and negligible donor site.