Abstract
Reconstructive surgeries for volar oblique amputation of the fingertip generally involve advancement flaps and reverse digital artery flaps. However, some advancement flaps cause flexion contracture of the PIP joint. The purpose of this study was to report the surgical outcome of venous flaps containing a Y-shaped vein for reconstruction following volar oblique fingertip amputation, focusing on PIP joint contracture.
Seven fingers of five patients were enrolled in this study. All fingers underwent volar oblique amputation distal to the DIP joint. Venous flaps containing a Y-shaped subcutaneous vein were harvested from the ipsilateral forearm. Two efferent veins were anastomosed to the radial and ulnar digital arteries at the DIP joint level. The afferent vein was coagulated.
Six flaps survived. Four flaps became congested, and were treated with medical leeches. The average total active motion was 237 degrees, average flexion of the PIP joint was 99.2 degrees, and the average extension of the PIP joint was −3.3 degrees.
Our method for reconstruction of the volar oblique fingertip using a venous flap containing a Y-shaped vein was useful and caused less flexion contracture of the PIP joint.
