Groin Flap Reconstruction for Finger Defects: A Case Series and Analysis of Clinical Outcomes

The groin flap, a reliable pedicled flap first described by McGregor and Jackson, remains a valuable reconstructive option for digital soft tissue defects, especially in settings lacking microsurgical resources. Despite its widespread use, few studies have comprehensively assessed risk factors associated with flap failure and postoperative complications. A retrospective case-control study was conducted on 46 patients who underwent groin flap reconstruction for finger defects between 2015 and 2024. Patients were grouped according to flap success and the occurrence of postoperative complications. Demographic, clinical, and operative variables were compared using appropriate statistical tests. Flap success was achieved in 93.5% (n = 43) of cases. Flap failure (n = 3) was associated with higher body mass index (BMI) (29.1 versus 24.5), smaller flap width (3.3 versus 5.5 cm, P = 0.02), and shorter operative time (37.7 versus 55.2 min, P = 0.02). Among the 17 patients (37%) who developed complications, smoking (100% versus 72.4%, P = 0.017), higher BMI (27.1 versus 23.4, P = 0.008), and venous congestion (94.1% versus 17.2%, P < 0.001) were significant predictors. Other variables, including defect and flap size, were not statistically different between groups. Groin flaps offer high success rates for finger reconstruction; however, increased BMI, smoking, and venous congestion are significant risk factors for postoperative complications. These findings underscore the importance of patient optimization and vigilant postoperative monitoring to improve surgical outcomes.