Dorsally extended digital island flap for repairing soft tissue injury of the fingertip

Iwasawa, Motonao; Kawamura, Tatsuro; Nagai, Fumio

doi:10.1016/j.bjps.2011.04.026

Cited by 12 publications

(5 citation statements)

References 13 publications

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“…The nature of these flaps allows the surgical scars to affect only one side of the finger. The dorsal surface of the finger remains intact unlike other homodigital flaps, such as the homodigital dorsal middle phalangeal neurovascular advancement flap (Ozaksar et al, 2010) or dorsally extended digital island flap (Iwasawa et al, 2011). Because the OTF includes a neurovascular bundle, immediate recovery of sensation is expected.…”

Section: Introductionmentioning

confidence: 99%

Homodigital artery flap reconstruction for fingertip amputation: a comparative study of the oblique triangular neurovascular advancement flap and the reverse digital artery island flap

Usami

Kawahara

Yamaguchi

et al. 2013

J Hand Surg Eur Vol

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This fingertip reconstruction study retrospectively compared sensory recovery and active range of motion outcomes in neurovascular island advancement and reverse digital artery island flaps. Seventeen oblique triangular flaps and 14 reverse digital artery island flaps were performed for nail bed level fingertip amputations (Ishikawa subzone II). There was no significant difference between the two procedures in the Semmes-Weinstein monofilament test and range of motion results. For static and moving two-point discrimination tests, however, those with a reverse digital artery island flap required a longer period for sensory recovery compared to those with an oblique triangular advancement flap. This trend equilibrated at 12 months after surgery showing no significant difference in both static and moving two-point discrimination tests between the procedures.

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Section: Introductionmentioning

confidence: 99%

Homodigital artery flap reconstruction for fingertip amputation: a comparative study of the oblique triangular neurovascular advancement flap and the reverse digital artery island flap

Usami

Kawahara

Yamaguchi

et al. 2013

J Hand Surg Eur Vol

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“…Typically, advancement with the triangular flap described by Atasoy et al ranges from 2-4 mm, can extend up to 12 mm with an oblique triangular flap, and may reach 19 mm with a step-advancement island flap. [21][22][23] Generally, a safe advancement length is considered to be 10 mm, though advancements of up to 30 mm have been achieved without complications. [24] Our anterograde-designed flap has no limitations in terms of flap advancement.…”

Section: Discussionmentioning

confidence: 99%

Bone grafting combined with a spiral flap technique for the reconstruction of fingertip amputations

Ceran

2024

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Various reconstructive options exist for distal finger and pulp defects, including grafting and local or distant flaps. In addition to reconstructing the normal anatomical structure, preserving the sensory function of the finger is crucial. This study presents the results of using bone grafting combined with a spiral flap (BGcSF) technique for reconstructing pulp defects accompanied by bone loss. METHODS: Twenty-three patients with fingertip defects were treated using the BGcSF technique. Flap sensitivity was assessed using the Semmes-Weinstein monofilament (SWM) and static two-point discrimination (2PD) tests at six months postoperatively. Cold intolerance of the affected fingers was evaluated using the Cold Intolerance Severity Score (CISS) questionnaire at one year postoperatively. Patient satisfaction was assessed using the Michigan Hand Outcomes Questionnaire (MHQ). Range of motion (ROM) for the proximal and distal interphalangeal joints was measured with a goniometer at one year postoperatively. RESULTS: Distal flap necrosis, affecting 10-15% of the flap area, was observed in one patient. No other complications were noted. The mean static two-point discrimination value at six months postoperatively was 5.6 mm, and the mean SWM score was 3.56. The mean CISS score at one year postoperatively was 18.8. The mean active ROM angle for the proximal interphalangeal joint was 106.7 degrees, and for the distal interphalangeal joint, it was 65.4 degrees. The mean MHQ score at one year postoperatively was 18.5. CONCLUSION: The BGcSF technique provides soft tissue with a texture similar to that of the fingertips and supports effective sensory repair. It can be considered a viable option for fingertip reconstruction in cases where replantation is not feasible.

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“…The mean length of advancement of the oblique triangular flap is 12 mm (Sano et al, 2008) and the corresponding value of the step-advancement island flap is 19 mm (Hammouda et al, 2011), but the latter has the disadvantage that scars remain all over the finger. It has been reported that an advancement of up to 30 mm is possible and that a mean advancement of 10 mm is safe and does not result in complications including flexion contracture (Iwasawa et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Modified anterograde pedicle advancement flap in fingertip injury

Lee

Jang

Kim

et al. 2014

J Hand Surg Eur Vol

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Soft tissue reconstruction is needed to maintain the maximum length of the fingers in fingertip injury. The purpose of this study was to present an anterograde pedicle advancement flap technique, for the treatment of fingertip injuries, which involved a modification to the anterograde advancement flap by the dissection of the digital nerve and artery with a pedicle to advance the flap. This technique was used in 12 fingers in patients who had undergone soft tissue reconstruction of fingertip injuries between January 2012 and October 2013. The sizes of the flaps ranged from 8 × 7 mm to 14 × 10 mm. The mean length of advancement was 9.7 mm (range 7-13). The mean value of the static two-point discrimination test of the healed flaps was 5.1 mm (range 4-6) and the flaps survived in all the 12 cases. The modified anterograde pedicle advancement flap provides a reliable coverage of sensate soft tissue without bone shortening in fingertip injuries.Level II.

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Dorsally extended digital island flap for repairing soft tissue injury of the fingertip

Cited by 12 publications

References 13 publications

Homodigital artery flap reconstruction for fingertip amputation: a comparative study of the oblique triangular neurovascular advancement flap and the reverse digital artery island flap

Homodigital artery flap reconstruction for fingertip amputation: a comparative study of the oblique triangular neurovascular advancement flap and the reverse digital artery island flap

Bone grafting combined with a spiral flap technique for the reconstruction of fingertip amputations

Modified anterograde pedicle advancement flap in fingertip injury

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