Abstract:
Background Gunshot injury to the hand is severe trauma, requiring complicated reconstruction surgery for the
damaged anatomic site to restore all the hand functions. The aim of this study was to show the example of the
distal phalanx reconstruction by using a flap with distal transverse digital artery (DTDA) blood supply as well as to
demonstrate the utility of the audio Doppler application at the reconstruction stage in the combat patient injured in
the Russo-Ukrainian war.
Case presentation In this report, we present a case of a 26-year-old service member of the Ukrainian Armed Forces
delivered to the Military Medical Clinical Centre on the fourth day after the gunshot gutter shrapnel wound of the
distal flexor of the 2nd digit with a gunshot fracture of the ungula (distal) and middle phalanges of the 2nd digit of
the right hand along with a bone deficiency of the osseous structure of the distal and middle phalanges, volar soft
tissues. The dorsal metacarpal artery (DMCA) flap is a universal variant among the tools of the reconstructive plastic
surgeon engaged in reconstructing defects of the digital dorsum and flexors with a limited range of flaps. We consider
this to be a key that conforms with the majority of the reconstructive principles, such as ‘analog replacement’, and
which is simple, adequate, and easy for operating with a minimal sequela of the donor site.
Conclusions The distal transverse digital artery (DTDA) could be considered for hand reconstructive surgery for
repairing defects of the flexor surface of the digit injury and hands after severe gunshot injury.
