Introduction: Fillet flaps are axial-pattern composite flaps harvested from unsalvageable parts, providing coverage without additional donor-site morbidity. Their application in the hand allows functional reconstruction with minimal sequelae.
Case Presentation: A 30-year-old man sustained a hand injury with dorsal avulsion and distal phalanx loss of the middle finger, preserving a viable volar fillet flap; and a dorsal defect with bone exposure on the ring finger. The distal fillet flap was split longitudinally: the radial half covered the middle finger stump, and the ulnar half was inset as a cross- finger flap to ring finger. Division occurred at three weeks, and full motion was regained by three months.
Discussion: Compared with reverse cross-finger, thenar, or homodigital reverse-flow flaps, each associated with flexion immobilization or donor-site morbidity, the split fillet flap minimized functional impairment.
Conclusion: This case highlights the versatility of the spare-part principle, enabling dual defect coverage with excellent outcomes.
International Journal of Case Reports in Orthopaedics
