Combination of the Adipofascial Cross-Finger Flap and Glabrous Skin Graft for Fingertip Reconstruction

Abstract

Objectives: Fingertip injuries are common, and there are many techniques used for reconstruction. The authors reviewed the outcomes of fingertip reconstruction, including sensation and shape, using the combined technique of the adipofascial cross-finger flap and glabrous skin graft and defined the optimal dimensions of fingertip defect that is applicable to this technique.

Methods: Between 2006 and 2016, 10 cases, aged 3-60 years (mean, 28.1 years), who had undergone fingertip reconstruction using a combination of the adipofascial cross-finger flap and glabrous skin graft were reviewed. The presence of fingertip and nail deformity and the results of the Semmes-Weinstein monofilament and static two-point discrimination tests were analyzed.

Results: Fingertip deformity was noted in three cases where the defect was more than 50% of the Tamai zone I or extended to zone II. Mild nail plate deformity was found in three cases with more than 40% of the nail bed defect. Two of these three cases presented with partial phalangeal tuft defects. Eight fingers were examined using the Semmes-Weinstein test, and their scores were between 2.83 and 4.31 in five fingers and 4.56 in three fingers. Six were examined for static two-point discrimination, with 5 mm in three, 6 mm in one, and 10 mm in two. The color and contour of all donor fingers were almost typical.

Conclusions: The combination of the adipofascial cross-finger flap and full-thickness glabrous skin graft is applicable to around 50% of fingertip defect within the Tamai zone I, achieving a satisfactory shape and regaining more than protective sensation.