The Qatari Flap for Fingertip Reconstruction: Versatility, Reliability, Clinical Applications, and Review of Literature

Abstract

Background: Fingertip injuries are common; when the bone is exposed, it requires more than skin to cover the defect. After the introduction of the concept of perforator flaps, trials have been made to reconstruct finger defects with perforator flaps. Here, we describe a series of fingertip injuries that were treated with reverse flow island finger perforator flap. Methods: We had 36 patients from January 2019 to June 2021, most of them male workers. We reported on the sizes of the defects and donor sites, the need to cover the pedicle with a skin graft, and complications. Patients were followed up for a period of 6 months, and the detailed elevation technique was mentioned. Results: Thirty-four flaps survived completely. In 50% of the cases, patients had congestion and epidermolysis with preserved underlying flap, which had normal healing course. Two patients with diabetes had infections; one of them had 40% necrosis of the flap, and one additional case had superficial eschar with preserved underlying flap tissues. Conclusions: Fingertip reconstruction rather than bone shortening is preferred to maintain the finger length. Multiple choices were suggested, but this flap had the disadvantage of limited coverage. After introducing the concept of perforator flaps into finger reconstruction, still more choices were added. The retrograde island digital artery perforator flap is a reliable choice, which is done in one stage and does not require loss of the digital artery.