Repair of a palmar soft tissue defect of the proximal interphalangeal joint with a transposition flap from the dorsum of the proximal phalanx

Abstract

This article describes the use of a transposition flap raised from the dorsum of the proximal phalanx for coverage of the volar defects at the proximal interphalangeal joint. The flap was based on the first dorsal branch of the proper digital artery. From January 2007 to March 2009, 14 digits in 14 patients (10 males and 4 females) were treated. There were 5 index, 6 middle, 2 ring, and 1 little finger. All patients underwent surgery 2–9 hours (mean 5 hours) after injury. Soft tissue defects ranged in size from 1.2 × 1.7 cm to 2.1 × 2.3 cm (mean 1.7 × 2 cm). Flap size ranged from 1.5 × 1.7 cm to 2.4 × 2.7 cm (mean 2 × 2.4 cm). Mean pedicle length was 1.1 cm (range 0.8–1.4 cm). All flaps completely survived. At final follow-up from 24–29 months (mean 26 months), mean active motion arcs of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 84° (range 75–91°), 86° (range 65–100°) and 54° (range 32–80°), respectively. Our technique is useful and reliable for coverage of a palmar defect over the proximal interphalangeal joint.