Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip
Background Fingertip injuries involving subtotal or total loss of the digital pulp are common types of hand injuries and require reconstruction that is able to provide stable padding and sensory recovery. There are various techniques used for reconstruction of fingertip injuries, but the most effec...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2012-11-01
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| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2012.39.6.637 |
| _version_ | 1817988970096623616 |
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| author | Nae-Ho Lee Woo-Sik Pae Si-Gyun Roh Kwang-Jin Oh Chung-Sang Bae Kyung-Moo Yang |
| author_facet | Nae-Ho Lee Woo-Sik Pae Si-Gyun Roh Kwang-Jin Oh Chung-Sang Bae Kyung-Moo Yang |
| author_sort | Nae-Ho Lee |
| collection | DOAJ |
| description | Background Fingertip injuries involving subtotal or total loss of the digital pulp are common types of hand injuries and require reconstruction that is able to provide stable padding and sensory recovery. There are various techniques used for reconstruction of fingertip injuries, but the most effective method is functionally and aesthetically controversial. Despite some disadvantages, cross-finger pulp flap is a relatively simple procedure without significant complications or requiring special techniques.
Methods This study included 90 patients with fingertip defects who underwent cross-finger pulp flap between September 1998 and March 2010. In 69 cases, neurorrhaphy was performed between the pulp branch from the proper digital nerve and the recipient's sensory nerve for good sensibility of the injured fingertip. In order to evaluate the outcome of our surgical method, we observed two-point discrimination in the early (3 months) and late (12 to 40 months) postoperative periods.
Results Most of the cases had cosmetically and functionally acceptable outcomes. The average defect size was 1.7×1.5 cm. Sensory return began 3 months after flap application. The two-point discrimination was measured at 4.6 mm (range, 3 to 6 mm) in our method and 7.2 mm (range, 4 to 9 mm) in non-innervated cross-finger pulp flaps.
Conclusions The innervated cross-finger pulp flap is a safe and reliable procedure for lateral oblique, volar oblique, and transverse fingertip amputations. Our procedure is simple to perform under local anesthesia, and is able to provide both mechanical stability and sensory recovery. We recommend this method for reconstruction of fingertip injuries. |
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| id | doaj.art-78235027e6154b25a0b1c2447b273b00 |
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| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-14T00:41:33Z |
| publishDate | 2012-11-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-78235027e6154b25a0b1c2447b273b002022-12-22T02:22:10ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712012-11-01390663764210.5999/aps.2012.39.6.637Innervated Cross-Finger Pulp Flap for Reconstruction of the FingertipNae-Ho Lee0Woo-Sik Pae1Si-Gyun Roh2Kwang-Jin Oh3Chung-Sang Bae4Kyung-Moo Yang5Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, KoreaDepartment of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, KoreaDepartment of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, KoreaDepartment of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, KoreaDepartment of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, KoreaDepartment of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, KoreaBackground Fingertip injuries involving subtotal or total loss of the digital pulp are common types of hand injuries and require reconstruction that is able to provide stable padding and sensory recovery. There are various techniques used for reconstruction of fingertip injuries, but the most effective method is functionally and aesthetically controversial. Despite some disadvantages, cross-finger pulp flap is a relatively simple procedure without significant complications or requiring special techniques. Methods This study included 90 patients with fingertip defects who underwent cross-finger pulp flap between September 1998 and March 2010. In 69 cases, neurorrhaphy was performed between the pulp branch from the proper digital nerve and the recipient's sensory nerve for good sensibility of the injured fingertip. In order to evaluate the outcome of our surgical method, we observed two-point discrimination in the early (3 months) and late (12 to 40 months) postoperative periods. Results Most of the cases had cosmetically and functionally acceptable outcomes. The average defect size was 1.7×1.5 cm. Sensory return began 3 months after flap application. The two-point discrimination was measured at 4.6 mm (range, 3 to 6 mm) in our method and 7.2 mm (range, 4 to 9 mm) in non-innervated cross-finger pulp flaps. Conclusions The innervated cross-finger pulp flap is a safe and reliable procedure for lateral oblique, volar oblique, and transverse fingertip amputations. Our procedure is simple to perform under local anesthesia, and is able to provide both mechanical stability and sensory recovery. We recommend this method for reconstruction of fingertip injuries.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2012.39.6.637finger injuriessubcutaneous tissuemicrosurgerynerve transfer |
| spellingShingle | Nae-Ho Lee Woo-Sik Pae Si-Gyun Roh Kwang-Jin Oh Chung-Sang Bae Kyung-Moo Yang Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip Archives of Plastic Surgery finger injuries subcutaneous tissue microsurgery nerve transfer |
| title | Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip |
| title_full | Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip |
| title_fullStr | Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip |
| title_full_unstemmed | Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip |
| title_short | Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip |
| title_sort | innervated cross finger pulp flap for reconstruction of the fingertip |
| topic | finger injuries subcutaneous tissue microsurgery nerve transfer |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2012.39.6.637 |
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