Changes in the size of the Distal Phalanx included in wrap-around flap and in the flap circumference for finger and thumb reconstruction

Matsusue, Takeo; Yoshimi, Ikuma; Kimura, Koji

doi:10.1016/j.bjps.2021.05.054

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…These measurements are based on research describing the author's 20 WAF cases, which showed that the average width reductions for the distal phalanx included in WAF was 1.2 mm and the flap circumference at the proximal nailfold was not greatly changed. 8 It is important that the WAF design includes the skin area of the lateral nailfold to be reconstructed.…”

Section: Ideamentioning

confidence: 99%

Easy and Simple Techniques to Reconstruct Natural Nailfold with the Wrap-around Flap for Finger Reconstruction

Matsusue

2022

Arch Plast Surg

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The wrap-around flap (WAF) has become a popular approach to thumb reconstruction because the results are functionally and cosmetically excellent. By modifying to a partial toenail transfer, the WAF can also be used for finger reconstruction. However, performing cosmetically superior finger reconstruction is a significant challenge because it is difficult to reconstruct the natural nailfold by partial nail transplantation, although partial nail transplantation is required to reconstruct a narrow fingernail. One side of the reconstructed lateral nailfold tends to be a missing nail margin, and one side of the proximal nailfold angle tends to be retracted. Based on the rationale that loss of the lateral nailfold volume due to the postoperative tension of the volar flap would result in a missing nail margin, the volume of the lateral nailfold was maintained with a single thread that was passed from the nail to the volar flap. Additionally, half of the proximal nailfold from the nail plate was elevated to advance it forward. The results indicated that a cosmetically natural nailfold was achieved with the WAF approach to finger reconstruction. These easy and simple techniques enable reconstruction of a cosmetically natural nailfold using WAF for finger reconstruction.

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Section: Ideamentioning

confidence: 99%

Easy and Simple Techniques to Reconstruct Natural Nailfold with the Wrap-around Flap for Finger Reconstruction

Matsusue

2022

Arch Plast Surg

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“…Partial toe transfer is an established procedure for distal finger reconstruction (Foucher et al, 1980; Morrison, 1992; Morrison et al, 1980). Free nail transfer, in which a toe flap with a short vascular pedicle is transplanted, using advanced microvascular surgical technology, has been commonly practiced (Adani et al, 1999; Adani et al, 2005; Del Piñal, 2019; Hirase et al, 1997; Koshima et al, 1989; Lee et al, 1995; Matsusue et al, 2021; Rui et al, 2010; Wei et al, 2003). However, existing procedures for aesthetic distal finger reconstruction leave a skin defect at the donor site in the great toe (Ma et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Distal finger reconstruction technique combining a distally‐based finger flap and a partial toe flap

et al. 2022

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Background: Although aesthetic reconstruction of an amputated distal finger can be achieved through partial toe transfer, this approach often damages the weightbearing region of the toe from which the flap is harvested. The purpose of this report is to introduce the minimum invasive surgery technique to reconstruct the distal finger aesthetically without damaging the weight-bearing region of the toe.Patients and Methods: Thirty-one amputated fingertips in 30 patients aged 18 to 68 years were treated using this operative technique. Operations were performed between January 2010 and December 2020. All patients were missing the distal finger beyond the PIP joint, and the amputation stump had been covered with healthy skin. A distally based finger flap was elevated at the recipient site, and a slender partial toe flap, including the nail, was harvested from the great toe. These flaps were combined to form the distal finger. In all cases, the weight-bearing region of the toe remained intact. The donor site wound was first closed with artificial dermis, and skin grafting was performed 3 weeks after the surgery. A few patients did not require skin grafting because their wounds epithelized spontaneously. Results:In most patients, the transplanted flap remained healthy and the distal finger was aesthetically restored. Two patients aged over 60 years who were smokers developed necrosis of the transplanted partial toe flap. In all patients, the weightbearing region of the great toe was intact, and they had no trouble walking during the three-year follow-up period after surgery. Conclusion:Our technique, which combines elevation of a distally-based finger flap and transplantation of a partial toe flap, was able to minimize the skin defect area in the great toe. This new distal finger reconstruction technique is minimally invasive and can be used to prevent secondary donor site issues.

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The reconstruction of fingertip injury with partial defect of nailbed and skin by hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation：a retropective study

Zheng,

Wang,

Zhou

et al. 2024

Preprint

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Introduction:How to reconstruct fingertip injury with partial defect of nailbed and skin is a clinical problem. Our team design the hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein to reconstruct fingertip injury with partial defect of nailbed and skin for a long time. Thus, we perform the retrospective study to evaluate the effects of this technique on fingertip injury with partial defect of nailbed and skin. Materials and methods:A retrospective analysis was performed on 40 patients with fingertip injury with partial defect of nailbed and skin admitted to our hospital from January 2016 to January 2020 who were treated by the hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein. During the follow-up, we recorded the operation time, intraoperative blood loss, the size of the transplanted flap, complications, the survival rate of the transplanted flap, total nail growth time, Semmes-Weinstein evaluating tactile sensation, two-point discrimination testing (TPD) and observed the appearance of reconstructed fingertip. Results:The operation time was (3.62±0.47) hours, the intraoperative blood loss was (31.77±4.54) ml, the size of transplanted flap was 12 mm × 7 mm to 19 mm × 10 mm, the survival rate of the transplanted flap was 100%. During the (26.82±4.47) months follow-up, the total nail growth time was (9.14±1.78) months and there is no complications. The average tactile sensation evaluated by the Semmes-Weinstein test and the average TPD of reconstructed fingertip was (0.31±0.15) g and (7.26±1.26) mm separately. The reconstructed fingertips had beautiful appearance and walking function of foots providing flaps was not influenced. Conclusions:The hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation is an effective method to reconstruct fingertip injury with partial defect of nailbed and skin with a beautiful appearance and excellent function. Type of study/level of evidence Therapeutic IV.

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Changes in the size of the Distal Phalanx included in wrap-around flap and in the flap circumference for finger and thumb reconstruction

Cited by 3 publications

References 5 publications

Easy and Simple Techniques to Reconstruct Natural Nailfold with the Wrap-around Flap for Finger Reconstruction

Easy and Simple Techniques to Reconstruct Natural Nailfold with the Wrap-around Flap for Finger Reconstruction

Distal finger reconstruction technique combining a distally‐based finger flap and a partial toe flap

The reconstruction of fingertip injury with partial defect of nailbed and skin by hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation：a retropective study

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