Restoration of Function and Sensitivity Utilizing a Homodigital Neurovascular Island Flap after Amputation Injuries of the Fingertip

Varitimidis, S.; Dailiana, Zoe; Zibis, Aristeidis; Hantes, Michael; Bargiotas, K.; Malizos, K.N.

doi:10.1016/j.jhsb.2005.04.014

Cited by 44 publications

(38 citation statements)

References 19 publications

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“…9% of our studies (n=4) reported pinch strength. 17,23,28,39 Mean pinch strength was 3 ± 1 kg (n=2), ranging from 2–5 kg (Table 5). 17,39 Overall, local flaps outperformed revision amputation in preserving PIP AOM, but slightly underperformed in preservation of TAM.…”

Section: Resultsmentioning

confidence: 99%

“…26,30,31,35,37,54,56 16% of our studies (n=7) evaluated cosmetic satisfaction. 17,21,27,39,43,45,55 85% of patients (112/131) reported “satisfactory” ratings and 98% of patients (105/107) reported “good” or “excellent” ratings, irrespective of treatment. 9% of our studies (n=4) evaluated other PRO measures, such as the Disabilities of the Arm, Shoulder, and Hand (DASH) score.…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Outcomes after Revision Amputation for Treatment of Traumatic Finger Amputation

Yuan

McGlinn

Giladi

et al. 2015

Plastic and Reconstructive Surgery

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Background Revision amputations are often the treatment for traumatic finger amputation injuries. However, patient outcomes are inadequately reported, and their impact poorly understood. We performed a systematic review to evaluate outcomes of revision amputations and amputation wound coverage techniques. Methods We searched all available English literature in PubMed and EMBASE for articles reporting outcomes of non-replantation treatments for traumatic finger amputation injuries, including revision amputation, local digital flaps, skin grafting, and conservative treatment. Data extracted were study characteristics, patient demographic data, sensory and functional outcomes, patient-reported outcomes (PROs), and complications. Results 1659 articles were screened, yielding 43 studies for review. Mean static 2-point discrimination (2-PD) was 5.0 ± 1.5 mm (n=23 studies) overall. Mean static 2-PD was 6.1 ± 2.4 mm after local flap procedures and 3.8 ± 0.4 mm after revision amputation. Mean total active motion (TAM) was 93 ± 8% of normal (n=6 studies) overall. Mean TAM was 90 ± 9% of normal after local flap procedures and 95% of normal after revision amputation. 77% of patients report cold intolerance after revision amputation. 91% of patients (217/238) report “satisfactory” or “good/excellent” ratings regardless of treatment. Conclusion Revision amputation and conservative treatments result in better static 2-PD outcomes compared to local flaps. All techniques preserve TAM, although arc of motion is slightly better with revision amputation. Revision amputation procedures are frequently associated with cold intolerance. Patients report “satisfactory,” “good,” or “excellent” ratings in appearance and quality of life with all non-replantation techniques. Level of Evidence III

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Outcomes after Revision Amputation for Treatment of Traumatic Finger Amputation

Yuan

McGlinn

Giladi

et al. 2015

Plastic and Reconstructive Surgery

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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: 98%

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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“…These seemingly mundane injuries represent a significant cost to society and to the affected individuals for treatment and from losses due to decreased production. Persistent cold intolerance [1, 8, 23–25], tenderness, and disfigurement [1, 8, 11] may have a major long-term impact on personal and professional activities [26]. In each case, the final outcome depends to some degree on the initial treatment, which may cause more disability than the injury itself.…”

Section: Discussionmentioning

confidence: 99%

Digital Tip Amputations from the Perspective of the Nail

Champagne

Hustedt

Walker

et al. 2016

Advances in Orthopedics

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The management strategy proposed herein for fingertip amputations advocates secondary healing with preservation of appearance as well as function. Conservative healing is more likely to result in a sensate, nontender, and cosmetically acceptable fingertip compared to surgical management in many clinical scenarios. This manuscript examines in detail the extent of fingertip injury and defines the relationship of injury to final fingertip outcome. A classification is presented, which allows adequate initial counseling regarding prognosis, and predicts the need for secondary corrective surgery.

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Restoration of Function and Sensitivity Utilizing a Homodigital Neurovascular Island Flap after Amputation Injuries of the Fingertip

Cited by 44 publications

References 19 publications

A Systematic Review of Outcomes after Revision Amputation for Treatment of Traumatic Finger Amputation

A Systematic Review of Outcomes after Revision Amputation for Treatment of Traumatic Finger Amputation

Maximal advancement of homodigital neurovascular island flaps

Digital Tip Amputations from the Perspective of the Nail

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