The Modified Cross Finger Flap for Finger Pulp and Nail Bed Reconstruction

Špokevičius, Saulius; Gupta, Amit

doi:10.1016/s0266-7681(97)80438-x

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…The cross finger skin flap, which was first reported by Gurdin and Pangman, [ 7 ] is a classical surgical method to reconstruct soft tissue defects on the thumb or fingers. Spokevicius and Gupta [ 8 ] described a modification of the cross finger skin flap procedure to enhance the amount of soft tissue under the volar flap, permitting reconstruction of the nail bed. However, this surgical method could not be used for distal phalanx exposure.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of large area defect of the nail bed by cross finger fascial flap combined with split-thickness toe nail bed graft

Yang

Wang²,

Yu³

et al. 2017

Medicine

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Fingertip injury commonly results in avulsion of the nail bed. For large area defects of the nail bed with distal phalanx exposure, methods for reconstruction of soft tissue defects are scarcely mentioned in the literature.From May 2014 to January 2016, 6 patients with large area defects of the nail bed with distal phalanx exposure were enrolled. A new surgical method, cross finger fascial flap combined with thin split-thickness toe nail bed graft, was applied in all patients.All the 6 patients were followed-up at least 3 months. Good blood supply and no infections were observed. The lengths of the thumb or fingers were preserved. Acceptable appearance and nail bed growth were noted. The donor sites showed no dysfunction or deformity.Cross finger fascial flap combined with thin split-thickness toe nail bed graft is a new and rewarding surgical method to reconstruct large area defect of the nail bed with distal phalanx exposure.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of large area defect of the nail bed by cross finger fascial flap combined with split-thickness toe nail bed graft

Yang

Wang²,

Yu³

et al. 2017

Medicine

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“…Although free tissue transfer, such as wrap-around flaps [12,13], can provide sufficient soft tissue to cover the defects, free tissue transfer is a risky selection in that total flap loss may occur if vascular troubles develop. Cross-finger flaps [8,9] categorized as heterodigital flapsare easy to raise and can provide sufficient tissue. Furthermore, cross-finger flaps are stable in terms of Type 2 Injuries involving the pulp and nail bed Type 3 Injuries with partial loss of the distal phalanx Type 4…”

Section: Discussionmentioning

confidence: 99%

“…Among reported reconstruction methods of the finger pulp are homodigital flaps [2-7], heterodigital flaps [8,9], thenar flaps [10,11], and free tissue transfer [12,13]. In performing reconstruction for type 3 and type 4 injuries, autologous bone grafts are often used in combination with these methods.…”

Section: Introductionmentioning

confidence: 99%

Combined usage of hydroxyapatite and cross-finger flap for fingertip reconstruction

Nagasao

Kurihara

Shimizu

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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Reconstruction for fingertip defects categorized as Type 3 and Type 4 in Allen's classification is challenging, because surgeons need to reconstruct not only the pulp but also great parts of the distal phalangeal bone. This paper introduces an original technique for the reconstruction of defects of these types. The defects of seven fingers (two small fingers and five index fingers) of seven patients (three males and four females; aged 14-44 years) were repaired. After the fingertip is divided in a fish-mouth fashion to expose the stump of the distal phalangeal bone, a curved block of hydroxyapatite is grafted to fill the phalangeal defect and straighten the nail bed. A rectangular flap is raised from the dorsal side of the neighbouring finger in the region between the PIP and DIP joints. Then the fish-mouth region carrying the grafted hydroxyapatite is covered with the rectangular flap to reconstruct the pulp. The rectangular cross-finger flap is separated 3-4 weeks postoperatively. In all seven cases, the flap survived completely. Infection developed in no case. In all cases, aesthetic appearance of the pulp and nail presented improvement, satisfying the patients. Combined usage of hydroxyapatite and a cross-finger flap from the neighbouring finger is an effective method for the reconstruction of type 3 and type 4 defects in Allen's classification.

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“…Another breakthrough in use of cross finger flap came when Martin [23] suggested use of reverse cross finger flap, not to cover a defect but as a vascularized vein graft carrier in 3 cases of Wolff class II & III ring avulsion injuries by creating venous anastomoses dor-vicus and Gupta [44] presented 2 cases in which they harvested innervated cross finger flap along with some extra subcuticular tissue from adjacent phalanx, which was used to cover nail bed defect in one case and in the other to provide bulk to the finger pulp. They reported no donor morbidity or flap necrosis.…”

Section: Modificationsmentioning

confidence: 99%

Timeline of Cross Finger Flap: From its Inception to its Future

Chakraborty¹,

Acharya²,

Midya³

et al. 2021

Trauma Cases Rev

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Since the first description of the cross-finger flap in 1950 for finger injury defect cover, over the last 70 years it has been tremendously explored and has underwent innumerable refinements and modifications. Whether used alone or in combination with other flaps for the reconstruction of finger defects, traumatic or non-traumatic, cross finger flap has proven its worth as a workhorse for finger reconstruction. Despite a handful of innate disadvantages, it has given excellent sensory, functional, and aesthetic outcomes in vast majority of studies. This article has been an attempt to reveal the entire rich journey and inexhaustible history of cross finger flap. With such a grandiose potential, it only seems that the cross finger flap will be continuously evolving over time and keep serving mankind in better ways.

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The Modified Cross Finger Flap for Finger Pulp and Nail Bed Reconstruction

Abstract: We describe a modification of the cross finger flap procedure. The modification enhances the amount of soft tissue under the flap, permitting reconstruction of the nail bed where necessary. We present two clinical cases.

Cited by 7 publications

References 21 publications

Reconstruction of large area defect of the nail bed by cross finger fascial flap combined with split-thickness toe nail bed graft

Reconstruction of large area defect of the nail bed by cross finger fascial flap combined with split-thickness toe nail bed graft

Combined usage of hydroxyapatite and cross-finger flap for fingertip reconstruction

Timeline of Cross Finger Flap: From its Inception to its Future

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