• Injury · Nov 2013

    Reconstruction of a soft tissue defect in the finger using the heterodigital neurocutaneous island flap.

    • Chao Chen, Peifu Tang, and Lihai Zhang.
    • Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, Hebei 063000, PR China; Affiliated Hospital of North China Coal Medical College (Hebei United University), Tangshan, Hebei 063000, PR China. Electronic address: ts_chenchao@163.com.
    • Injury. 2013 Nov 1;44(11):1607-14.

    BackgroundThis article describes reconstruction of a soft tissue defect in the finger using the heterodigital neurocutaneous island flap and reports the results of the use of the flap.MethodsFrom February of 2008 to March of 2011, the neurocutaneous island flap was used in 12 patients with soft tissue defects in the middle phalanx or the proximal interphalangeal joint, or both. The injured fingers included 4 index, 3 middle, 3 ring and 2 little fingers. The donor fingers included 7 middle fingers and 5 ring fingers. The mean size of soft tissue defects and the flaps was 2.4 cm × 1.8 cm and 2.7 cm × 2.0 cm, respectively. The mean pedicle length was 2.8 cm.ResultsFull flap survival was achieved in 11 cases. Partial distal flap necrosis was noted in one case, which healed without surgical intervention. At a mean follow-up of 22 months, the mean static 2-point discrimination and Semmes-Weinstein monofilament scores on the flap were 8.3mm and 3.94, respectively. Based on the modified American Society for Surgery of the Hand guidelines for stratification of 2-point discrimination, 10 (83%) of 12 flaps achieved good results. According to the Michigan Hand Outcomes Questionnaire, 5 patients were strongly satisfied and 7 were satisfied with functional recovery of the reconstructed finger.ConclusionsThe neurocutaneous island flap of the dorsal branch of the digital nerve is useful, reliable, and technically easy for reconstructing a defect in the adjacent fingers, especially when sensory reconstruction is needed.Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

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