The homodigital neurovascular antegrade island flap for fingertip reconstruction in children

We describe a homodigital neurovascular island flap for fingertip reconstruction in children and review the appearance and function of the reconstructed fingertips. Eleven children, with a mean age of 4 years (range : 2-7),who had sustained a fingertip injury with total or subtotal pulp loss were treated with a homodigital neurovascular island flap between 2007 and 2009. The flaps were harvested based on a single digital neurovascular bundle without further shortening of the distal phalanx. The average follow-up period was 15 months (range : 10-32 months). The clinical outcome evaluations included the defect size of the flap, the static two-point discrimination, total active motion (TAM) of the PIP and DIP joints and time to return to daily activities. Patient satisfaction with function and cosmesis were also evaluated. All of the flaps survived without any painful scar formation, hypersensitivity or cold intolerance and no interphalangeal joint contractures were noted. The average two point discrimination ranged from 3 to 4 mm, with an average of 3.4 mm. All the patients were satisfied with the function and appearance of the involved finger. Our study suggests that the homodigital neuro vascular is a reliable choice of treatment for children fingertip defects.