Reverse Palmar Flaps for Triphalangeal Finger Defects: An Anatomical Study and Case Series
Abstract
Objective: To describe the anatomical consistency of palmar cutaneous branches and commissural arteries, and to evaluate patients treated with reverse palmar flaps. Materials and Methods: Anatomical study: five cadaveric hands were analyzed to assess the consistency of palmar cutaneous branches, as well as commissural and transverse interphalangeal arteries. Clinical study: patients with palmar digital injuries in triphalangeal fingers treated with palmar flaps were included, with no age restriction, no prior surgical history, with or without associated injuries, and a minimum follow-up of 24 months. Subjective evaluation included the Visual Analog Scale (VAS) for pain and the QuickDASH score. Objective evaluation included the two-point discrimination test and goniometric assessment of total active motion (TAM) according to the Strickland system. Results: The anatomical study demonstrated consistent palmar cutaneous branches (2–4 branches per flap island), as well as the presence of commissural and transverse interphalangeal arteries. The clinical study included 10 patients (8 men and 2 women). Eight short and two long palmar flaps were performed. The postoperative VAS score was 1/10 and the QuickDASH score was 2.5. Two-point discrimination was 7 mm. According to TAM (Strickland classification), 6 results were excellent, 3 good, and 1 fair. Conclusions: Palmar cutaneous branches and anastomotic systems were found to be consistent. The reverse pedicled palmar flap proved to be an effective option for the treatment of digital defects.Downloads
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