Published in:
01-10-2016 | Original Article
Thumb Tip Defect Reconstruction Using Neurovascular Island Pedicle Flap Obtained From Long Finger
Published in: Aesthetic Plastic Surgery | Issue 5/2016
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Introduction
Thumb tip reconstruction has been a very challenging issue for hand surgeons. Varieties of reconstructive options have been described or modified to obtain satisfactory sensory recovery. However, none has yielded entirely satisfactory results. This study reports a retrospective review of clinical data records of patients treated with a neurovascular island pedicle flap obtained from the medial aspect of the long finger.
Methods
We enrolled 15 patients (9 men and 6 women), who received neurovascular island pedicle flaps for thumb tip amputations between December 2011 and December 2015. The average size of the flap was 2.8 × 2.2 cm2 (range 2.5 × 1.8 cm2 to 3.5 × 2.5 cm2). At the final follow-up visits, static two-point discrimination, visual analogue scale, Michigan hand outcome questionnaire and return-to-work time were used to evaluate surgical outcomes.
Results
All flaps survived well. The follow-up period was 18 months. The mean static 2PD values at the reconstructed thumb tip and donor finger pulp (medial side) were 5.3 mm (range 4–8 mm) and 3.2 mm (range 3–4 mm), respectively. The average VAS scores for the aesthetic appearance of the donor site and recipient site were 9.1 (range 8–10) and 9.0 (range 8–9.5), respectively. The average Michigan Hand Outcome Questionnaire (MHOQ) score for hand function (reconstructed hand) was 8.2 (range 6–16). The average RTW time was 8.4 weeks (range 7–12 weeks).
Conclusions
Neurovascular island pedicle flap obtained from the medial aspect of long finger is a very reliable alternative technique for thumb tip defect reconstruction.
Level of Evidence V
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