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Journal of Hand Surgery (British and European Volume)
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Articles

The Dorsal Middle Phalangeal Finger Flap

Mid-term results of 43 cases

P. LEUPIN
J. WEIL
U. BÜCHLER

From the Division of Hand Surgery, Inselspital, University of Berne, Switzerland

Correspondence: Prof. Dr U. Büchler, Handchirurgische Abteilung, Inselspital, CH-3010, Bern, Switzerland.

The dorsal middle phalangeal finger (DMF) flap is a (neuro)vaseular island flap based on one palmar proper digital artery, its venae comitantes (and/or a separate dorsal vein) and the dorsal branch(es) of the palmar digital nerve. The main nerve supply of the donor finger is left undisturbed. The flap may be raised on a short antegrade, long antegrade or a retrograde pedicle, and used as a free, arterial and/or venous flow-through or neurovascular flap. In a prospective study (mean follow-up of 50 months), the results of 43 DMF flaps were analysed. All flaps survived, retained patency of their vascular pedicles and fulfilled their goals. Neurovascular flaps provided sensate coverage at the S3+ level with static 2-point discrimination values of about 10 mm. Dissection between the proper digital nerve and the rest of the neurovascular bundle induced a 5% incidence of cold intolerance and a 12% occurrence of S3+ hypaesthesia. Advantages, drawbacks and indications of DMF flaps are outlined.

Journal of Hand Surgery (British and European Volume), Vol. 22, No. 3, 362-371 (1997)
DOI: 10.1016/S0266-7681(97)80403-2
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