A Systematic Review of the Sensory Outcomes of a Standard Cross-Finger Flap Reconstruction for Fingertip Defects

Abstract

Background: The standard (dorsal) cross-finger flap (CFF) is one of the common flaps used for fingertip reconstruction. There is little consensus regarding the sensory outcomes associated with this flap. In this systematic review, we evaluated objective sensory outcome parameters of patients who underwent CFF reconstruction. Methods: This systematic review is reported using the PRISMA protocol and was registered with the International Prospective Register of Systematic Reviews. Literature search was done using the terms ‘cross-finger flap’, ‘heterodigital’, ‘finger-tip’ and ‘transdigital’. Data regarding the number of patients, follow-up duration and sensory outcomes, including 2-point discrimination (2-PD) were extracted from included studies. The analysis was performed using Microsoft Excel with MetaXL add-in software. Certainty assessment and summary of findings table was created using GRADEpro GDT. Results: This review includes 14 studies with 301 patients. We found a statistically significant difference in static 2-PD of recipient and control fingers (pooled weighted mean difference [WMD]: 1.66; 95%CI: 0.03, 3.29; p = 0.00; I2=92%, n = 7 studies). Conclusions: Dorsal CFF reconstruction for fingertip defect does not provide adequate sensory recovery. Level of Evidence: Level III (Therapeutic)

Reconstruction of Composite Soft Tissue Defect in the Distal Finger Using Partial Toenail Flap Transfer

“…The nail is always simultaneously damaged with the finger pulp, and the tendon and bone can be exposed. Various methods, such as the V‐Y advancement flap, 6 the digit neurovascular flap, 7 the metacarpal artery flap, 8 and the cross‐finger flap 9 (all classical resurfacing treatments for a fingertip), have been widely used since microsurgical techniques were first developed. These flaps fail to reconstruct the nail in cases of multiple tissue defects and do not achieve cosmetic satisfaction, affecting the patient's pinching ability and confidence.…”

Local flaps of the hand

“…Der kan vaere donorstedsmorbiditet i form af nedsat bevaegelighed pga. kontraktur af fuldshudstransplantatet, derfor er fysio-og ergoterapi efter kirurgi afgørende for optimal funktion af både donor-og recipientfingeren [17].…”

Langzeitergebnisse nach Rekonstruktion von Fingerdefekten mittels Cross-Finger-Lappenplastik

“…Die Cross-Finger-Lappenplastik in der ursprünglichen Form, die durch Cronin 1951 erstmals beschrieben wurde, ist asensibel. In der Literatur ist die Datenlage hinsichtlich des Wiedererlangens der Sensibilität im Bereich der transplantierten Cross-Finger-Lappenplastik umstritten, sodass der Einsatz vor allem im Bereich der Endgliedrekonstruktion zurückhaltend indiziert wird [12]. In unserer Studie stellt sich jedoch im Bereich der rekonstruierten Finger durchschnittlich eine ausreichende 2-Punkte-Diskriminationsfähigkeit dar, welche die Patienten/-innen im Alltag nur wenig einschränkt.…”