Atasoy Flap Fingertip Reconstruction: Long-term Patient-reported Outcomes in Male Laborers

Abstract

Background: Atasoy flaps (AFs) are commonly used to reconstruct digits after fingertip injuries. However, recent literature reports that some surgeons prefer skeletal shortening and closure, presumably because the procedure can be performed in the emergency department without the risk of flap-associated complications. The purpose of the present outcome study is to evaluate patient-reported, long-term satisfaction of AF reconstructions for fingertip injuries. Methods: Adult, male patients working in manual labor occupations who underwent AF reconstruction for fingertip injuries were identified from an institutional database. Patients were administered an injury-specific questionnaire relating to nail growth, function, aesthetics, cryalgia, and hypersensitivity. They were then administered the QuickDASH questionnaire to report standardized functional impairment and asked about their overall satisfaction with their reconstructed finger. Results: Twelve patients underwent AF fingertip reconstruction between 2015 and 2020. Eleven of these patients agreed to be interviewed, the majority having been treated in the emergency department setting. The overall satisfaction rate was 91% (n = 10). Common sequelae included hook nail 64% (n = 7), cold sensitivity 45% (n = 5), and hypersensitivity 27% (n = 3). There were no flap failures or tissue necrosis. One patient reported a second surgery for improvement of a hook nail deformity. Conclusions: Long-term outcomes of AF reconstruction for fingertip injuries demonstrate high overall satisfaction. Patients appreciated tissue salvage to preserve digit length, even in those unconcerned with aesthetics. Issues reported by patients, such as cold intolerance, hook nail, and decreased tactile sensation, are similar to other treatment options for fingertip injuries.

Homodigital Unipedicled Islanded Neurovascular Pulp Advancement Flap/Colombo Flap for Fingertip Reconstruction: A Case Series with a Novel Technique

“…4 However, hook nail deformity, reduction of ROM at the DIPJ, and cold intolerance are still reported as long-term problems. 4 5…”

“…4 However, hook nail deformity, reduction of ROM at the DIPJ, and cold intolerance are still reported as long-term problems. 4,5 Pedicled neurovascular flaps provide longer advancement, and they can be used in VO amputations. Biddulph's modifications of the Kutler and Venkataswami flaps are examples for these flaps and they also reported better outcomes in the literature.…”