Free radial forearm flap for near total degloving finger reconstruction

Background: Total circumference degloving injury of the digits usually results in a large cutaneous defect with tendinus structure and bone and joint exposure. A thin and adequately sized flap is required when revasculization is not possible to resurface the defect, restore the finger function, and prevent amputation. Materials and Methods: In this report, we present our experience on reconstruction of total circumferential degloving injury on the digits using free radial forearm (RF) flaps in 6 patients. Between February 2006 and January 2011, 6 male patients with circumferential degloving injury of 6 digits underwent reconstruction with the free RF flaps. The average flap size was 15.8×7.1 cm. Donor sites were covered with split-thickness skin graft (STSG). Results: All of flaps survived completely and donor sites healed without complications. The mean follow-up period was 22 months. A maximum Kapandji score (10/10) was seen in 2 cases with crushed thumbs. All patients could achieve good key pinch and grasping functions. All skin flaps showed acceptable static 2-point discrimination with an average of 10.2 mm (range, 8-12 mm) and adequate protective sensation. Patient satisfaction for resurfaced digits averaged 9.3 (range, 9-10 mm) on a 10-points visual analogic scale (VAS). Conclusion: In conclusion, the free RF flaps were thin and did not interfere with finger movements. The patients could attain smooth finger contours and acceptable function results after reconstruction. This method may be a valuable alternation for reconstruction of total circumference avulsion injury of the digits. © 2012 JMS.