Homodigital neurovascular island flaps in hand surgery. A study of sixty cases.

The homodigital island flap is a useful technique in problem cases such as distal amputation of the pulp, atrophic or insensative pulp on the index finger or thumb and painful neuromas. In a series of 60 operations preformed by one surgeon with the SOS Main in Strasbourg, we describe the indications for, and results of, several different techniques: unipedical flaps either advanced or "exchanged" and bipedical flaps either advanced or retreated.

[Hueston's flap for reconstruction of loss of distal thumb substance].

The classical rotation flap described by J. Hueston involves the advancement of a denervated skin area on the distal stump. In distal amputations of the thumb, this flap should only be used on the lateral side in order to avoid creating a blind medial pulp.

Technique and indications of the forearm flap in hand surgery. A report of thirty-three cases.

The Chinese forearm flap is vascularized by the radial artery and may be used as an island or a free flap. Used as an island flap, the pitfalls of the microsurgical procedures required for a free flap, may be avoided. Vascular anastomosis is easily performed owing to the large diameter of the vessel.

Single stage thumb reconstruction by a composite forearm island flap.

Single stage thumb reconstruction is possible with a new composite skin bone flap from the forearm. The primary vascularisation of skin and bone avoids the disadvantages of the conventional multi-staged procedures such as neurovascular insufficiency, infection and bone absorption. It does not require a surgical team with microsurgical expertise.