[Pedicled flap procedures for sensory restoration of the hand: long-term results].

Abstract

OBJECTIVES:

We evaluated the long-term results of patients who underwent reconstruction with pedicled flaps for soft tissue and sensory restoration.

METHODS:

The study included 30 patients (26 males, 4 females; mean age 33 years; range 16 to 62 years) who underwent sensory restorations of the thumb (n=24), the index finger (n=3), and the little finger (n=3). Twenty-seven patients received neurovascular island flaps and three patients received radial innervated cross-finger flaps. Disconnection-reconnection of the nerve was performed in 11 patients receiving a neurovascular island flap. Sensory evaluations were made with two-point discrimination and the Semmes-Weinstein monofilament test. The mean follow-up was 29.2 months (range 5 to 144 months).

RESULTS:

There were no cases of flap loss. Contractures of donor digits were seen in four patients (14.8%) treated with neurovascular island flaps. Neuroma formation was noted in two patients (18.2%) in whom the disconnection-reconnection technique was used. Static and moving two-point discrimination test results were 9.1 mm and 7.4 mm with the disconnection-reconnection technique, 8.3 mm and 7 mm with the original technique, and 10.3 mm and 8.6 mm with radial innervated cross finger flaps, respectively. Sensation was at the recipient site in all the patients who underwent disconnection-reconnection. Of those in whom the original technique was employed, nine patients (56.3%) localized sensation at the recipient site, three patients (18.8%) at the donor site, while four patients (25%) showed double sensibility.

CONCLUSION:

Pedicled flaps are reliable and satisfactory alternatives for soft tissue and sensory restoration of hand injuries and disconnection-reconnection of the nerve is effective in preventing double sensibility.

• Authors: Türker Ozkan, Fatih Kabakaş, Atakan Aydin, Bülent Yaprak, Eftal Güdemez
• Journal: Acta orthopaedica et traumatologica turcica (Acta Orthop Traumatol Turc) Vol. 40 Issue 2 Pg. 117-22 ( 2006) ISSN: 1017-995X [Print] Turkey
• Vernacular Title: Elin duyu restorasyonu için pediküllü flep uygulamalari ve geç dönem sonuçlar.
• PMID: 16757927 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adolescent
• Adult
• Female
• Finger Injuries (surgery)
• Fingers (innervation)
• Humans
• Male
• Middle Aged
• Plastic Surgery Procedures
• Sensation
• Surgical Flaps
• Thumb (injuries, innervation)
• Treatment Outcome