Cross finger flap for reconstruction of complex finger defects

Traumatic hand injuries are commonly due to machinery accidents, road traffic accidents and are usually severe. Among the hand injuries, fingertips are most frequently injured. Injuries to the underlying structures of hand carry the potential for serious handicap and can lead to significant functional and cosmetic deficits. Phalangeal defects exposing bone and tendons always require flap coverage. Cross finger flap is a good option to cover such complex phalangeal defects. Over two year’s period, twenty-two patients with complex phalangeal defects were operated. Traditional dorsal cross finger flap coverage was performed after detail explanation of the procedure. All flaps survived with good functional and aesthetic outcomes. The defects size ranged from 1.8 × 1.5 cm to 2.4 × 1.6 cm. Donor site defects covered with split thickness skin graft and well taken. Temporary joint stiffness was present following flap separation and resolved completely after physiotherapy. Dorsal cross finger flap is a versatile flap for the palmar phalangeal region defects, lateral oblique, volar oblique and transverse finger amputation defects. The flap is simple to perform, reliable and allows preserving the length, contour, and retention of sensation and function of the digit.