Reverse homodigital artery versus reverse dorsal homodigital island flaps for fingertip defect repair: A meta-analysis.

Abstract

This review aimed to systematically and comprehensively compare the effectiveness and applicability of reverse homodigital artery island flaps (RHAIF) and reverse dorsal homodigital island flaps (RDHIF) to treat fingertip defects. A comprehensive search was conducted in multiple databases for studies that compared RHAIF versus RDHIF for treating fingertip defects with no language restrictions from inception until July 31, 2022. A meta-analysis was performed using RevMan 5.4 software. A total of 14 articles were retrieved, comprising 484 patients (509 fingers) in the RHAIF group and 453 patients (484 fingers) in the RDHIF group. The pooled estimates suggested that patients treated with RHAIF experienced more donor-side complications and less postoperative venous crisis than patients in the RDHIF group. On the other hand, no significant differences were found in operative time, flap necrosis, static 2-point discrimination, moving two-point discrimination, total active motion, satisfaction rates and sensory recovery grade (S3+ to S4) between the RHAIF and RDHIF groups. No difference in effectiveness was found between the two surgical procedures for treating fingertip defects. Accordingly, the selection of the optimal approach should be based on the functional requirements of the patient and the surgeon's expertize.