The boomerang flap in managing injuries of the dorsum of the distal phalanx

Finding an appropriate soft-tissue grafting material to close a wound locat ed over the dorsum of a finger, especially the distal phalanx, can be a dif ficult task. The boomerang flap mobilized from the dorsum of die proximal p halanx of an adjacent digit can be useful when applied as an island pedicle skill flap. The vascular supply to the skin flap is derived from the retro grade per-fusion of the dorsal digital artery. Mobilization and lengthening of the vascular pedicle are achieved by dividing the distal end of the dor sal metacarpal artery at the bifurcation and incorporating two adjacent dor sal digital arteries into one. The boomerang flap was used in seven individuals with injuries involving th e dorsal aspect of the distal phalanx over the past year. Skill defects in all patients were combined with bone,joint, or tendon exposure. The authors found that the flap was reliable and technically simple to design and exec ute. This one-step procedure preserves the proper palmar digital artery to the f ingertip and has proven valuable for the coverage of wide and distal defect s because it has the advantages of an extended skin paddle and a lengthened vascular pedicle. When conventional local flaps are inadequate, the boomer ang flap should be considered for its reliability and low associated morbid ity.