Combined ipsilateral and contralateral second toe flaps for repair of finger degloving injury

Zhang, Guangliang; Ju, Jihui; Zhao, Qiang; Li, Xiangjun; Jin, Guangzhe; Tang, Linfeng; Hou, Ruixing

doi:10.1002/micr.22253

Cited by 7 publications

(3 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, the total donor site morbidity is minimized. 38 In our series, no significant difference was seen in the averaged TAM between the injured or donor fingers and the contralateral fingers. Meanwhile, early rehabilitation with the help of a physical therapist is also very important.…”

Section: Discussioncontrasting

confidence: 52%

“…Two fingers each contribute a smaller flap, thereby leading to each finger having less donor morbidity, such as skin graft contracture and extensor tendon adhesion. Thus, the total donor site morbidity is minimized 38 . In our series, no significant difference was seen in the averaged TAM between the injured or donor fingers and the contralateral fingers.…”

Section: Discussionmentioning

confidence: 45%

See 1 more Smart Citation

Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap

Wang

et al. 2022

Ann Plast Surg

View full text Add to dashboard Cite

BackgroundThe reconstruction of a fingertip degloving injury presents a functional and aesthetic challenge. We used a dorsal digital perforator flap combined with a cross-finger flap to reconstruct this type of injury. The purposes of this retrospective study were to evaluate the efficacy of the combined flaps and to present our clinical experience.MethodsFrom November 2016 to October 2019, 16 patients (13 men and 3 women) with fingertip degloving injuries were treated with a dorsal digital perforator flap combined with a cross-finger flap for innervated reconstruction. We used an innervated dorsal digital perforator flap for the reconstruction of the dorsal defect of the degloved fingertip and an innervated cross-finger flap for the volar defect. The average size of the defect was 4.2 × 1.9 cm. The average sizes of the flaps were 2.3 × 2.1 cm (the dorsal digital perforator flap) and 2.5 × 2.1 cm (the cross-finger flap).ResultsAll flaps and skin grafts survived completely without ischemia or venous congestion. All wounds and their donor sites healed primarily without exudation and infection. Patients were followed up for a mean time of 11.3 ± 1.9 months (range, 9–15 months). At the final follow-up, no significant difference was seen in the averaged total active motion between the injured fingers and the contralateral fingers. No significant difference was found in the averaged total active motion between the donor fingers and the contralateral fingers. All flaps obtained excellent or good sensory performance. All flaps had mild cold intolerance. Thirteen patients had no pain, 2 reported mild pain, and 1 experienced moderate pain. Ten patients were very satisfied with the appearance of the reconstructed finger.ConclusionsThe dorsal digital perforator flap combined with a cross-finger flap is an effective and reliable method for the reconstruction of fingertip degloving injuries.

show abstract

Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 45%

Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap

Wang

et al. 2022

Ann Plast Surg

View full text Add to dashboard Cite

show abstract

“…The further improvements, described in the literature, in a wraparound fashion include the following: (1) extend proximally with a dorsalis pedis flap for the coverage of the dorsal finger; (2) combine with a second toe tibial flap for the coverage of the volar finger; (3) extract the dorsal nail-skin flap with a fibular hemipulp flap, supplied by the neurovascular bundle; (4) preserve the plantar triangular flap, instead of a few tibial strips 11 ; (5) sculpture the iliac bone graft into a conical contour to prevent bulging pulp 12 ; (6) dissect a great toe hemipulp flap with a second toe nail-skin flap for coverage of the distal finger; (7) combine ipsilateral second toe dorsal nail-skin flap with the contralateral second toe fibular flap for coverage of the distal finger 13 ; and (8) use bilateral lateral hallux osteo-onychocutaneous free flaps for reconstruction of the distal finger. 14 In the twist-toe technique for finger reconstruction, the tip of the distal phalanx could be taken with the nail to preclude nail deformity.…”

Section: Discussionmentioning

confidence: 99%

Combined great toe dorsal nail-skin flap and medial plantar flap for reconstruction of degloved finger loss

Lin

Zhou

Huang

et al. 2023

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Background: Historically, the degloved finger with the total loss of nails and skin has been resurfaced in two stages. Furthermore, proximal finger amputation requires an additional bone-tendon graft and an expanded great toe wraparound flap transfer for better outcomes. This article recommends a novel strategy to address these problems in a single stage using a dorsal nail-skin flap and medial plantar artery perforator flap. Methods: From March of 2015 to June of 2018, nine procedures were performed to resurface with skin loss to the metacarpophalangeal joint level, and three amputated fingers were reconstructed with an extra bone-joint-tendon graft simultaneously. The dorsal great toe donor was covered with a thin groin flap, and the medial plantar site was covered with a full-thickness skin graft. A standardized assessment of outcome in terms of sensory, functional, and aesthetic performance was completed. Results: All flaps survived. The contour and length of the reconstructed digits were comparable with the contralateral finger. The mean static two-point discrimination was 11.0 mm (range, 9.0 to 14.0 mm). The average score of the Disabilities of the Arm, Shoulder, and Hand questionnaire and Michigan Hand Outcomes Questionnaire were 2.5 (range, 0 to 5) and 90.1 (range, 82 to 96), respectively. The mean Foot and Ankle Disability Index score was 95.6 (range, 93 to 99). At the last follow-up, the functional and aesthetic outcomes, and the restored sensation, were satisfactory for all fingers. Conclusion: This strategy may provide an alternative for selected patients seeking cosmetic resurfacing and functional reconstruction, preserving a weight-bearing plantar area with less morbidity. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

show abstract

Partial medial second toe pulp free flap and dermal substitute with skin graft for salvage reconstruction of a complete skin envelope degloving of the small finger

Calafat

Strugarek

Montoya-Faivre

et al. 2018

Annales de Chirurgie Plastique Esthétique

View full text Add to dashboard Cite

Combined ipsilateral and contralateral second toe flaps for repair of finger degloving injury

Abstract: The ipsilateral second toe dorsal nail-skin flap combined with contralateral medial second toe flap may provide an alternative for the reconstruction of completely degloved fingers at the middle and the distal phalangeal level, with satisfactory functional and cosmetic results.

Cited by 7 publications

References 41 publications

Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap

Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap

Combined great toe dorsal nail-skin flap and medial plantar flap for reconstruction of degloved finger loss

Partial medial second toe pulp free flap and dermal substitute with skin graft for salvage reconstruction of a complete skin envelope degloving of the small finger

Contact Info

Product

Resources

About