Local Flap Transfer on Finger Tip Injuries

Journal of the Korean Society for Surgery of the Hand 1996;1(1):83-90.
Published online January 1, 1996.

Jun Mo Lee,Hag Ji Kim

국소 피부판을 이용한 수지 말단부 손상의 치료

이준모,김학지

Abstract

No single technique is satisfactory for all finger tip reconstructions to provide a sensate digit, a padded digit, a pain free tip, maximum length, appropriate nail appearance and support, normal joint movement, and the best cosmesis, however, skin graft, local flap and regional flap are options being performed for coverage. The Atasoy V-Y volar flap is useful primarily when the distal phalanx is exposed with increased length volarly and more proximal injury dorsally. The Kutler flap is advanced from each side of the digit when the distal phalanx is exposed and angle of tissue loss is transverse. Thenar flap is benefitable to avoid PIP joint contracture in young women, and ipsilateral neurovascular island flap is useful for pulp loss. We have treated 22 cases of finger tip injuries in adults by Kutler-type lateral V-Y flap in 10 cases, Atasoy volar V-Y advancement flap in 8, thenar flap in 3, and ipsilateral neurovascular island flap in 1 from from March 1989 through February 1996 at Department of Orthopedic Surgery, Chonbuk National University Hospital. The results was summarized as follows. 1. Industrial injuries were the most common causes of the finger tip injuries(12 cases, 60%). 2. Index finger was most frequently sustained(9 cases, 45%). 3. Kutler's flap was designed to cover the exposed area of most of the injured finger tips(10 tips, 45%). 4. Static two-point discrimination test revealed injured finger tip was no more compatible to the intact contralateral one, but pinch function and contour of the finger tip was acceptable enough to return to the job among the industrial cases(8 cases, 67%).