Bilobed Flap Coverage for the Reconstruction of Dorsal Soft Tissue Defect Over the Proximal Phalanx: A Case Report

TL;DR

This case report describes using a bilobed flap to successfully reconstruct a soft tissue defect on a finger caused by an infection.

Contribution

The paper presents a practical, single-stage bilobed flap design for dorsal finger soft tissue reconstruction.

Findings

The bilobed flap provided effective coverage for an exposed extensor tendon with minimal complications.

The flap design allowed good functional recovery and minimal donor site morbidity.

This technique is suitable for dorsal proximal phalanx soft tissue defects.

Abstract

Soft tissue defects over the dorsal finger are common and may result from trauma, burns, or surgical management of infections and tumors. We present a case where a bilobed flap was used for the reconstruction of a soft tissue defect dorsal to the proximal phalanx of the ring finger and discuss the design of this flap. The defect was secondary to a collar button abscess of the right third webspace and the surgical debridement required to control the infection. The exposed extensor tendon over the proximal phalanx required coverage. The bilobed flap was designed with the first lobe over the right middle finger proximal phalanx and the second lobe over the right second webspace and index finger. The flap healed uneventfully and the patient had good functional recovery. This design for a bilobed flap is suitable for soft tissue reconstruction of defects over the dorsum of the proximal phalanx. It is a simple, reliable, single-staged procedure that provides like-for-like reconstruction and has minimal donor site morbidity.

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