Hatchet flap and rotation flap for distal dorsal finger defect reconstruction

Our patient is a 26‐year‐old man presented with deep abrasion over the palm in thenar eminence and the dorsum of index, middle, ring and little fingers over the distal and proximal phalanges. The injury over the ring, little and middle fingers had exposed distal inter‐phalangeal joint [Figure 1a]. The injury over the index finger was not exposing the joint, and that was closed primarily. The distal inter‐phalangeal joints of middle and ring fingers were destroyed with partial loss of head of the middle phalanges [Figure 1b] and these joints were arthrodesed and stabilised with 0.8 mm K‐wires. The defect over the middle finger was closed with hatchet flap and the defects over the little and ring fingers were managed with rotation flap raised from the dorsum, based medially [Figure 1c‐e]. The flaps survived completely giving good result. The aesthesis was acceptable after 2 months of the procedure [Figure 1f]. Active and/ or passive range of movements of all the digits’ joints after 31⁄2 years is seen in Video 1. The dorsal scars also were well‐settled over a period of 31⁄2 years of post‐surgery [Figure 2].