case_images: PMC10200088_01
case_images: Total traumatic avulsion of the fourth and fifth fingers, with preservation of the metacarpal bones and partial avulsion of 80% of the middle phalanx of the third finger
case_images: wjps-12-63-g001.jpg
case_images: PMC10200088_01_wjps-12-63-g001.jpg
case_images: F1
case_images: There was a loss of coverage on the palm and ulnar surface, and partial avulsion of the flexor digitorum profundus of the second finger (Fig 1).
case_images: Separation of the pedicled flap, resulting in good coverage of the skin defect and preservation of thumb opposition
case_images: wjps-12-63-g002.jpg
case_images: PMC10200088_01_wjps-12-63-g002.jpg
case_images: F2
case_images: After three weeks, during the second surgical procedure, the pedicle of the flap was separated, resulting in good coverage of the skin defect and preservation of thumb opposition, with the option for a future toe transfer (Fig 2).
case_images: PMC10200088_02
case_images: Total degloving of the second finger up to the base of the proximal phalanx, and total avulsion of the flexor digitorum profundus within the distal phalanx
case_images: wjps-12-63-g003.jpg
case_images: PMC10200088_02_wjps-12-63-g003.jpg
case_images: F3
case_images: Upon physical examination, he presented with total degloving of the second finger up to the base of the proximal phalanx, and total avulsion of the flexor digitorum profundus within the distal phalanx (Fig 3).
case_images: Groin flap tubular design to provide coverage of the entire surface of the second finger
case_images: wjps-12-63-g004.jpg
case_images: PMC10200088_02_wjps-12-63-g004.jpg
case_images: F4
case_images: The patient was taken to the operating room, and after surgical cleaning, a groin flap was designed to provide tubular coverage for the entire surface of the second finger (Fig 4).
case_images: PMC10200088_03
case_images: Total degloving injury of the thumb up to the proximal phalanx, with preservation of the insertion and function of all extensor and flexor tendons
case_images: wjps-12-63-g005.jpg
case_images: PMC10200088_03_wjps-12-63-g005.jpg
case_images: F5
case_images: Upon physical examination, the patient presented with total degloving of the thumb up to the proximal phalanx, with preservation of the insertion and function of all extensor and flexor tendons but lacking coverage of skin and soft tissues (Fig 5).
case_images: Result of tubular groin flap covering the entire circumference of the thumb after three weeks
case_images: wjps-12-63-g006.jpg
case_images: PMC10200088_03_wjps-12-63-g006.jpg
case_images: F6
case_images: He experienced a recovery of 80% of thumb movements (Fig 6).
case_images: PMC10200088_04
case_images: Partial degloving on the left palmar surface at the first interphalangeal joint resulting from electrical burn
case_images: wjps-12-63-g007.jpg
case_images: PMC10200088_04_wjps-12-63-g007.jpg
case_images: F7
case_images: Physical examination revealed partial function of the flexor tendon, preserved abduction and adduction of the thumb, bone and soft tissue loss with bone exposure, and lack of skin and soft tissue coverage (Fig 7).
case_images: Tubular design approach to cover affected area, preserve major blood supply, and prevent ischemia
case_images: wjps-12-63-g008.jpg
case_images: PMC10200088_04_wjps-12-63-g008.jpg
case_images: F8
case_images: We preferred to use a tubular design approach to preserve major blood supply and prevent ischemia (Fig 8).
case_images: Result of tubular groin flap covering the entire affected after three weeks
case_images: wjps-12-63-g009.jpg
case_images: PMC10200088_04_wjps-12-63-g009.jpg
case_images: F9
case_images: The flap was separated three weeks after the surgery under local anesthesia, and thumb function was deemed acceptable with preserved flexor and extensor tendons (Fig 9).
case_images: PMC10200088_05
case_images: Dry necrosis of distal phalanx, two weeks after right thumb avulsion and partial amputation
case_images: wjps-12-63-g010.jpg
case_images: PMC10200088_05_wjps-12-63-g010.jpg
case_images: F10
case_images: After two weeks, the distal phalanx suffered dry necrosis (Fig 10), so we decided to perform a groin flap for skin coverage of the bone and repaired tendons.
case_images: Contralateral groin flap covering bone and repaired tendons
case_images: wjps-12-63-g011.jpg
case_images: PMC10200088_05_wjps-12-63-g011.jpg
case_images: F11
case_images: An ipsilateral flap was not available due to two previous hernia surgeries the patient had undergone, so we harvested a contralateral flap instead (Fig 11).
case_images: Result of groin flap covering the affected area after redundant skin resection at one month
case_images: wjps-12-63-g012.jpg
case_images: PMC10200088_05_wjps-12-63-g012.jpg
case_images: F12
case_images: Both the functional and aesthetic results were better than we and the patient expected, considering the injury mechanism and the extent of soft tissue damage (Fig 12).