Posterior Auricular Artery Sensate Flap for Finger Pulp Reconstruction

Fingertip injuries constitute a large portion of the traumatic injuries sustained in the hand and are frequently associated with significant disability for the patient. Many techniques have been proposed for finger pulp reconstruction; however, results often involve the morbidities of poor sensibility, numbness, joint stiffness, and poor cosmesis. These authors proposed a free posterior auricular artery sensate flap for reconstruction of finger pulp injury with bone exposure. The posterior auricular artery sensate flap was based on the posterior auricular artery and vein, and innervated by the greater auricular nerve, which is a good choice for fingertip reconstruction. The flap provided wound coverage, good aesthetic results, and the donor site can be closed primarily without morbidity. The recovery of sensation in these cases was excellent. The free posterior auricular artery sensory flap has been utilized in 8 constructive index finger pulp injuries. All the flaps survived well with excellent sensory recovery. Microscopic evaluation of sensory return was presented.