Twin axial transposition flap for dorsal skin defects of the middle phalanx and proximal interphalangeal joint: Anatomical description

Abstract

Background: Dorsal skin defects of the middle phalanx and proximal interphalangeal joint (PIS) of the fingers are difficult to cover. However, a description is presented of novel flap called transposed twin axial flap. Transposition allows these defects to be covered.
Material and methods: This article discusses an anatomical study, performing dissections on 5 cadaveric models. Two of these dissections were performed by using colored acrylic with china blue dye. A dissection was also performed on a patient with severe hand trauma with vascular viability.
Results: The anatomical bases of the flap were established, demonstrating the proper vascularization of the transposed twin axial flap. The patient who received the flap showed vascular viability with good clinical results.
Discussion: The twin axial transposition flap is presented as a valid alternative to cover the defects described. It is easy, fast and safe to perform compared to other local flaps. A prospective randomized clinical trial should be performed to determine the possibilities of its routine use.