Bilobed Flap for Post-Traumatic Angular Deformity Correction of the Fingers in Children

Author(s): João Pedro Farina Brunelli, Ricardo Kaempf, Diego Falcochio

The Fingertip injuries, usually caused by domestic accidents, such as finger crushing in doors and windows, are very common in childhood. They can cause fractures, nail bed injuries and amputations, as well as combined injuries. Initial management, with correct diagnosis and treatment, is critical for the prevention of complications, whose incidence can reach almost 50% of cases. Severe injuries or inadequate treatment can compromise bone growth, causing deformities and loss of finger alignment, impairing function and skill development in later life.

We describe a surgical treatment technique for correcting cases of posttraumatic angular deformities of the distal interphalangeal (DIP) joint using a bilobed flap associated with bone reduction. This technique allowed achieving good skin coverage after bone realignment without requiring skin grafts or more complex flaps.

The bilobed flap proved to be a good tool for correcting severe angular deformities of the fingers in the pediatric population, allowing for large correction, and providing skin coverage that is easy to apply with tissue similar to the recipient area.

Its use minimizes the risk of complications associated with more complex flaps with less surgical time and predictable results.