A Simple, Single-Staged Pedicled Rotational Flap With Lateral Band Tendon Graft for the Reconstruction of Composite Dorsal Finger Defects

Composite defects over the dorsal finger are challenging to reconstruct, especially when they involve the eponychium and extensor tendon. We present a case series involving three patients where a single-stage pedicled rotational flap with lateral band tendon graft was used for the reconstruction of the composite defect at the dorsal distal or middle phalanx of the fingers. The flap was based on the dorsal skin branches of the digital arteries at the proximal phalanx and can extend distally to cover eponychial defects. Two of the three patients also had an extensor apparatus defect of 1.0 cm or more and were successfully reconstructed with a lateral band tendon graft with good functional outcomes. The flaps healed uneventfully. This flap with tendon graft technique offers a straightforward, reliable, single-stage reconstruction, providing like-for-like tissue replacement with minimal donor site morbidity.