Original article / research
Outcomes of the Reverse Homodigital Island Artery Flap in Fingertip Reconstruction: A Retrospective Study
PC23-PC26
Correspondence
Yadavalli RD Rajan,
207, Kaizen Satya Residency, Kanaka Durga Nagar-2, Vijayawada, Tirupati,
Andhra Pradesh, India.
E-mail: dryrdrajan@gmail.com
Introduction: Fingertip injuries are common hand traumas that often necessitate surgical reconstruction to restore both form and function while preserving sensation. The Reverse Homodigital Island Artery (RHDIA) flap has emerged as a reliable option for such defects.
Aim: To evaluate the outcomes of the RHDIA flap in fingertip reconstruction.
Materials and Methods: The present retrospective study was conducted between January 2024 and December 2024 in the Department of Plastic Surgery, Sri Venkateswara Medical College, Tirupati, Andhra Pradesh, India, including 15 patients with post-traumatic fingertip defects. Patients with prior surgery, burns, or contractures of the affected finger and immunocompromised status were excluded. The RHDIA flap was raised from the proximal phalanx of the same finger and transposed to resurface the fingertip defect, with donor sites closed primarily or covered with split-thickness skin grafts. Demographic, operative, and postoperative parameters were analysed using EPI info 7.2. Continuous data were presented as mean±Standard Deviation (SD) or median (IQR), and categorical variables were presented as frequencies and percentages.
Results: All 15 patients underwent fingertip reconstruction using the RHDIA flap with 100% flap survival. One patient (6.6%) developed partial distal necrosis that healed secondarily. The mean flap size was 3.7±0.22 cm², and mean healing time was 17.1±2.1 days. Functional outcomes were rated good to excellent in 93.3% (n=14) of cases, with high patient satisfaction in 86.6% (n=13). Aesthetic outcome was assessed using a 5-point Likert scale and the median score was 4 (IQR=2), indicating overall good aesthetic satisfaction. No donor-site complications, stiffness, or contracture were observed.
Conclusion: The RHDIA flap is a reliable, single-stage option for fingertip reconstruction, offering good tissue match and satisfactory functional and aesthetic outcomes. Although limited by small sample size and retrospective design, this study reinforces the role of RHDIA as an effective reconstructive modality for fingertip defects.