Long-term outcome of fingertip reconstruction with the homodigital neurovascular island flap

Arsalan-Werner, Annika; Brui, Natallia; Mehling, Isabella; Schlageter, M; Sauerbier, Michael

doi:10.1007/s00402-019-03198-4

Cited by 26 publications

(19 citation statements)

References 32 publications

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“…The maximal advancement of this flap has been reported to be in the range of 15–22 mm (Adani et al., 1997; Arsalan-Werner et al., 2019; Borman et al., 2000; Evans and Martin, 1988; Foucher et al., 1989; Lanzetta et al., 1995; Lok et al., 2017; Massart et al., 1985; Sano et al., 2008; Schuind et al., 1985; Usami et al., 2015, Varitimidis et al., 2005; Wang et al., 2011), which is summarized in Table 3. We have noted some deficiencies in the previous articles on homodigital neurovascular island flaps.…”

Section: Discussionmentioning

confidence: 97%

Maximal advancement of homodigital neurovascular island flaps

Lim

Chong

Sebastin

2019

J Hand Surg Eur Vol

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We investigated the maximal advancement of the homodigital neurovascular island flap with the digit in full extension and its correlation to the digital length. In 32 adult cadaveric digits, flaps measuring 1 × 1 cm were sequentially elevated to different dissection points. Dissection of the flap to the proximal interphalangeal joint crease, palmo-digital crease, division of adjacent digital artery and the superficial arch resulted in flap advancement of 8, 12, 15 and 18 mm, respectively. The degree of advancement correlated to the length of the finger and was approximately 19% of the finger length. We conclude that dissection of a homodigital antegrade neurovascular island flap to the proximal interphalangeal joint, palmo-digital crease, after ligation of adjacent digital artery and the superficial arch allows progressively more advancement. The advancement obtained by flap dissection to the palmo-digital crease was about 19% of the finger length.

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Section: Discussionmentioning

confidence: 97%

Maximal advancement of homodigital neurovascular island flaps

Lim

Chong

Sebastin

2019

J Hand Surg Eur Vol

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“…Hook nail deformity seems to be a frequently encountered complication, impairing the aesthetic results of paediatric fingertip reconstructions (Varitimidis et al., 2005), with an incidence of 7–50% in adults (Arsalan-Werner et al., 2019; Kayalar et al., 2011). Our study revealed that this problem is more common in paediatric patients, which does not seem to be related to the amount of bone loss supporting the nail bed.…”

Section: Discussionmentioning

confidence: 99%

“…Hook nail deformity was classified using the Lim classification (Lim et al., 2008) (Figure 1). An 11-point rating scale (0 = extremely dissatisfied, 10 = extremely satisfied) was used to evaluate overall patient satisfaction (Arsalan-Werner et al., 2019).…”

Section: Methodsmentioning

confidence: 99%

Long-term outcomes of homodigital neurovascular island flap reconstruction of fingertip injuries in children

Yıldırım¹,

Erol²,

Toros³

2022

J Hand Surg Eur Vol

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We evaluated the long-term functional and cosmetic results of homodigital neurovascular island flap (NIF) used to reconstruct extensive pulp defects with bone exposure in children. Twenty-three children (mean age 4.8 years, range 1–10 years) with fingertip injuries were reconstructed with a pedicled homodigital NIF and evaluated in terms of sensation quality, cold intolerance, scar formation, nail deformity, range of motion and overall finger length at a mean follow up of 7.8 years (range 2–13). Eleven patients reported cold sensitivity in the operated fingertip, and 15 presented with hook nail deformities at the final follow-up. The total active motion of the injured finger was significantly lower than that of the uninjured side ( p < 0.001). NIFs is a safe, reliable reconstructive treatment for fingertip loss in children, but commonly encountered issues in the long term include an extension lag of the interphalangeal joints, hook nail deformities and cold intolerance. Level of evidence: IV

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“…In previous studies, multiple soft tissue defects of fingers were reconstructed using regional flaps, multiple homodigital island flaps, multiple free flaps, and by syndactylization with various flaps such as venous free flap, fasciocutaneous flap, or thoracodorsal perforator flap. 1 2 3 4 In this study, we introduce an alternative treatment option to deal with multiple soft tissue defects of the fingers, namely, coverage with a single free lateral arm flap with temporary syndactylization and secondary release.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of Multiple Digital Defects by Temporary Syndactylization Using a Lateral Arm Free Flap

Park

YOON

et al. 2022

Arch Plast Surg

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Background Soft tissue defects of the multiple finger present challenges to reconstruction surgeons. Here we introduce the use of a lateral arm free flap and syndactylization for the coverage of multiple finger soft tissue defects. Methods This retrospective study was conducted based on reviews of the medical records of 13 patients with multiple soft tissue defects of fingers (n=33) that underwent temporary syndactylization with a microvascular lateral arm flap for temporary syndactylization from January 2010 to December 2020. Surgical and functional outcomes, times of flap division, complications, and demographic data were analyzed. Results Middle fingers were most frequently affected, followed by ring and index fingers. Mean patient age was 43.58 years. The 13 patients had suffered 10 traumas, 2 thermal burns, and one scar contracture. Release of temporary syndactyly was performed 3 to 9 weeks after syndactylization. All flaps survived, but partial necrosis occurred in one patient, who required a local transposition flap after syndactylization release. The mean follow-up was 15.8 months. Conclusion Coverage of multiple finger defects by temporary syndactylization using a free lateral arm flap with subsequent division offers an alternative treatment option.

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Long-term outcome of fingertip reconstruction with the homodigital neurovascular island flap

Cited by 26 publications

References 32 publications

Maximal advancement of homodigital neurovascular island flaps

Maximal advancement of homodigital neurovascular island flaps

Long-term outcomes of homodigital neurovascular island flap reconstruction of fingertip injuries in children

Reconstruction of Multiple Digital Defects by Temporary Syndactylization Using a Lateral Arm Free Flap

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