Comparison of the clinical effects of reverse digital artery island flap and dorsal branch digital artery island flap on digital tip reconstruction: a single-center retrospective study
DOI:
https://doi.org/10.2340/jphs.v60.44186Keywords:
Surgical flaps, reverse digital artery island flap, finger injuries, treatment outcomeAbstract
Background: This study aimed to compare the repairing effects of reverse digital artery island flap and dorsal branch digital artery island flap on fingertip defects.
Methods: From January 2023 to January 2024, analyzed retrospectively clinical data of 41 patients with fingertip defects who underwent two kinds of surgery. There were 24 patients in the reverse digital artery island flap group and 17 patients in the dorsal branch digital artery island flap group. The size of the defect area of the affected finger, the range of motion (ROM) of the interphalangeal joint, the operation time, the hospital stay and the cold tolerance were evaluated and compared.
Results: There was a significant difference between the reverse group and the dorsal branch group in the ROM of the proximal interphalangeal joint of the affected finger. The appearance of the affected finger was significantly better in the reverse group than in the dorsal branch group. There was no significant difference between the two groups in the area of defect of affected finger, ROM of distal interphalangeal joint, operation time, hospital stays, function of affected finger and cold tolerance of skin flap.
Conclusions: Compared with the dorsal branch digital artery island flap, the reverse digital artery island flap can provide better hand appearance. However, in terms of proximal interphalangeal joint ROM , the effect of dorsal branch digital artery island flap is better than that of reverse digital artery island flap.
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Zhang W, Fang J, Lu Y, et al. Bilateral flaps based on the dorsal branches of the proper digital artery: A reliable reconstruction in one-stage for the multiple defects in one finger. Injury. 2021;52(3):532–536. https://doi.org/10.1016/j.injury.2020.06.035 DOI: https://doi.org/10.1016/j.injury.2020.06.035
Ma J, Ding Y, Xu L, et al. Repair of fingertip defect with reverse digital artery island flap and repair of donor site with digital dorsal advancement flap. Front Surg. 2023;10:1127356. https://doi.org/10.3389/fsurg.2023.1127356 DOI: https://doi.org/10.3389/fsurg.2023.1127356
Takeishi M, Shinoda A, Sugiyama A, et al. Innervated reverse dorsal digital island flap for fingertip reconstruction. J Hand Surg Am. 2006;31(7):1094–1099. https://doi.org/10.1016/j.jhsa.2006.02.029 DOI: https://doi.org/10.1016/j.jhsa.2006.02.029
Chen QZ, Sun YC, Chen J, et al. Comparative study of functional and aesthetically outcomes of reverse digital artery and reverse dorsal homodigital island flaps for fingertip repair. J Hand Surg Eur Vol. 2015;40(9):935–943. https://doi.org/10.1177/1753193415579300 DOI: https://doi.org/10.1177/1753193415579300
Usami S, Kodaira S, Homma T, et al. Postoperative voluminal flap reduction after fingertip reconstruction using the reverse digital artery island flap. Hand Surg. 2015;20(1):133–136. https://doi.org/10.1142/S0218810415500197 DOI: https://doi.org/10.1142/S0218810415500197
Chen K, Yang S, Cheng Y, et al. Reverse homodigital artery versus reverse dorsal homodigital island flaps for fingertip defect repair: A meta-analysis. J Plast Reconstr Aesthet Surg. 2023;82:237–246. https://doi.org/10.1016/j.bjps.2023.04.015 DOI: https://doi.org/10.1016/j.bjps.2023.04.015
Han SK, Lee BI, Kim WK. The reverse digital artery island flap: Clinical experience in 120 fingers. Plast Reconstr Surg. 1998;101(4):1006–1011;discussion 1012–1013. https://doi.org/10.1097/00006534-199804040-00018 DOI: https://doi.org/10.1097/00006534-199804040-00018
Chen C, Tang P, Zhao G. Direct and reversed dorsal digital island flaps: A review of 65 cases. Injury. 2014;45(12):2013–2017. https://doi.org/10.1016/j.injury.2014.08.030 DOI: https://doi.org/10.1016/j.injury.2014.08.030
Feng SM, Sun QQ, Cheng J, et al. A novel approach for reconstruction of finger neurocutaneous defect: A sensory reverse dorsal digital artery flap from the neighboring digit. Orthop Surg. 2017;9(4):372–379. https://doi.org/10.1111/os.12350 DOI: https://doi.org/10.1111/os.12350
Xiong X, Xu M, Shuai M, et al. Comparative study of the clinical effects of reverse digital artery island flaps and antegrade homodigital neurovascular island flaps for fingertip reconstruction. Ann Plast Surg. 2022;88(4):395–400. https://doi.org/10.1097/SAP.0000000000002967 DOI: https://doi.org/10.1097/SAP.0000000000002967
Xie H, Fang Q, Zhang D. Flow-through flap with wrist epithelial branch of ulnar artery for repair of finger soft tissue defect: A case series. Am J Transl Res. 2021;13(8):9826–9830.
Chen C, Tang P, Zhang X. The dorsal homodigital island flap based on the dorsal branch of the digital artery: A review of 166 cases. Plast Reconstr Surg. 2014;133(4):519e–529e. https://doi.org/10.1097/PRS.0000000000000016 DOI: https://doi.org/10.1097/PRS.0000000000000016
Zhang Y, Zhou J, Qin J. Clinical effects of homodigital dorsal branch of the proper digital artery flap on repairing soft tissue defects of fingers. J Plast Surg Hand Surg. 2023;58:18–23. https://doi.org/10.2340/jphs.v58.11967 DOI: https://doi.org/10.2340/jphs.v58.11967
Ji Z, Nie R, Li S, et al. Clinical effects of resurfacing fingertip amputations in long fingers using homodigital dorsal neurofascial broaden pedicle island flaps. J Plast Surg Hand Surg. 2023;57(1–6):453–458. https://doi.org/10.1080/2000656X.2022.2152825 DOI: https://doi.org/10.1080/2000656X.2022.2152825
Luan Z, Liu B, Jiang H, et al. Reverse first dorsal metacarpal artery flap repair of a right thumb epidermis granuloma: A case study. Oncol Lett. 2019;18(3):2384–2387. https://doi.org/10.3892/ol.2019.10583 DOI: https://doi.org/10.3892/ol.2019.10583
Usami S, Kawahara S, Yamaguchi Y, et al. Homodigital artery flap reconstruction for fingertip amputation: A comparative study of the oblique triangular neurovascular advance flap and the reverse digital artery island flap. J Hand Surg Eur Vol. 2015;40(3):291–297. https://doi.org/10.1177/1753193413515134 DOI: https://doi.org/10.1177/1753193413515134
Sundaramurthy N, Venkata Mahipathy SRR, Durairaj AR. Why borrow from Peter when Paul can afford it? Reverse homodigital artery flap for fingertip reconstruction. Indian J Plast Surg. 2017;50(2):187–192. https://doi.org/10.4103/ijps.IJPS_98_17 DOI: https://doi.org/10.4103/ijps.IJPS_98_17
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Copyright (c) 2025 Yue Pan, Jun Lei, Jun Yang, Mingwei Dong, Shengjie Jiang, Guangchen Sun, Hui Yu
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