Reconstruction of Soft Tissue of the Finger Using Heterodigital Reverse Island Flap

Purpose Reconstruction of soft tissue defects of the fingers is still a challenge. Considering the special characteristics of finger skin, and the “like for like” principle, appropriate reconstruction should use local tissue as much as possible. Here, we introduce a reverse flow type of heterodigital island flap and evaluate the outcome of finger reconstruction using this technique. Methods Thirty-two patients who underwent finger reconstruction using heterodigital reverse island flaps between August 2014 and March 2017 were included in this study. The study population consisted of 25 male and 7 female patients, with a mean age of 27.5 years (range, 6–67 years). The defect ranged from 1.5 to 2.5 cm in length and from 1.0 to 2.1 cm in width. Results All 32 flaps survived intact. After 1 year, the range of motion in the proximal interphalangeal joint was 81.0 ± 5.1, and the range of motion in the distal interphalangeal joint was 71.2 ± 5.7. The mean static 2-point discrimination of the flaps was 5.3 mm (range, 2–8 mm), and the donor finger was 9.2 mm (range, 4–9 mm), which is regarded as good to excellent, by the Modified American Society for Surgery of the Hand Guidelines. The mean visual analog scale (VAS) pain score was 2.5 (range, 0–8). The mean Vancouver Scar Scale (VSS) score of the flap was 3.95 (range, 1–11), and that of the donor site was 1.76 (range, 0–5). The mean follow-up period was 21.6 months (range, 12–36 months). Conclusions Given its satisfactory esthetic and functional results, the heterodigital reverse island flap based on a long vascular pedicle in a reverse pattern is a feasible option for reconstruction of defects of the hand.