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J Hand Surg Am. 2013 Feb;38(2):350-6. doi: 10.1016/j.jhsa.2012.10.019. Epub 2012 Dec 6.

Innervated digital artery perforator flap.

Author information

1
Department of Orthopedics, and the Department of Plastic and Reconstructive Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey. ozcanli@akdeniz.edu.tr

Abstract

PURPOSE:

To describe a technique for covering defects of the fingertips: the innervated digital artery perforator (IDAP) flap.

METHODS:

A total of 17 patients were treated with an IDAP flap. The size of the flaps varied between 2 ×1 cm and 3.5 × 2 cm. Postoperative evaluation of the patients consisted of the Semmes-Weinstein Monofilament test, static 2-point discrimination, patient satisfaction, extension loss, and an investigation into complications.

RESULTS:

All IDAP flaps survived completely, and no patients required secondary interventions. The mean follow-up period was 7 months (range, 6-10 mo). The Semmes-Weinstein monofilament test results ranged from 3.22 to 3.84. The static 2-point discrimination in the flaps ranged from 2 mm to 4 mm (mean, 3.4 mm) compared with a range of 2 mm to 3 mm (mean, 2.7 mm) on the contralateral hand. There were no joint contractures in the reconstructed fingertips, although 2 patients developed mild hook nail deformity. One patient experienced mild cold intolerance, and 1 patient exhibited mild postoperative hypersensitivity.

CONCLUSIONS:

The advantages of the IDAP flap include minimally invasive surgery; a reliable, versatile flap; and the ease of the technique for different-sized fingertip defect reconstructions with few complications. The IDAP flap may be useful in fingertip amputations when the amputated part is not suitable for replantation.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Therapeutic IV.

PMID:
23218789
DOI:
10.1016/j.jhsa.2012.10.019
[Indexed for MEDLINE]
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