A 24-year-old man injured his right little finger when it was sandwiched by metal that was several hundred degrees. This heat press injury resulted in the loss of the dorsal part of the DIP joint, including its terminal tendon, and exposure of the DIP joint. To cover the defect, we performed one-stage reconstruction using the superficial palmar branch of the radial artery flap combined with the palmaris longus tendon. The donor site was closed primarily along the distal wrist crease. With additional vein anastomosis for postoperative congestion, the flap survived completely. One year after surgery, the DIP joint of the injured finger had an active ROM of －30° extension to 60° flexion. The patient responded to the 3.61 to 4.31 Semmes-Weinstein monofilament values in the flap. When the flap is designed with the volar part of the wrist, it can involve the palmaris longus tendon that is in the same operation field. Together, they can be used as a vascularized tendon flap. We suggest this flap as an effective method to restore function of the DIP joint after complex injuries of the skin and tendon defects.
