Reconstruction of cutaneous dorsal finger defects

Background: Reconstruction of surgical defects on the dorsal finger can be challenging because of a lack of adjacent tissue reservoirs, poor laxity, and often thin, atrophic skin surrounding the defect.Objective: To present reconstructive options for cutaneous dorsal finger defects.Methods: We describe our five preferred approaches to reconstructing cutaneous dorsal finger defects based on the amount of available underlying tissue and location of the defect on the finger.Results: In the authors’ opinion, for smaller defects between and including the metacarpophalangeal joint extending to the proximal interphalangeal joint, a transposition flap or unilateral advancement flap is preferable. For proximal finger defects that are wider, a unilateral rotation flap is appropriate. A Burow full-thickness skin graft can be used for any proximal defect with underlying soft tissue present. For defects with underlying bone or tendon present, a reverse cross-finger interpolation flap can be utilized.Conclusions: The unilateral advancement flap, unilateral rotation flap, transposition flap, full-thickness skin grafts, or the reverse cross-finger interpolation flap can be used to reconstruct the majority of cutaneous dorsal finger defects