Treatment of defects in the tip and palmar surface of the fingers

Abi-Chahla, Marie-Laure; Alet, J.-M.; Fabre, Thierry; Pélissier, P.

doi:10.1016/j.hansur.2017.11.003

Cited by 11 publications

(4 citation statements)

References 19 publications

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“…There are some reconstruction algorithms published. Most of the algorithms focus on fingertip and palm injuries ( 24 - 26 ). One of the previously published algorithms focuses specifically on pedicled coverage options for traumatic upper extremity soft tissue defects ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

A treatment algorithm for reconstruction of soft tissue defects in the hand: a narrative review

Nordback,

Hakkarainen,

Mattila

2023

Ann Transl Med

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Background and Objective The hand is the highly specialized distal construct of the upper limb with complex and intricate anatomy. Soft tissue defects can compromise this and result in significant functional impairment. Choosing the optimal reconstructive modality is essential for the best functional recovery. The objective of this narrative review was to provide a treatment algorithm for soft tissue defects in the hand. Methods Relevant literature for the topic was searched from PubMed and Cochrane Database from year 1953 up till end of November 2022. Specified searches for randomized controlled trials, systematic reviews and reviews were performed. Key Content and Findings There are no randomized controlled trials published on this topic. There are six systematic reviews or meta-analyses published. Most of the literature still comprises on expert opinion and case reports with few previously proposed algorithms. Defect features, size, location and depth, patient related factors and available resources are the main determinants of the treatment strategy. In the hand, there are reasonable locoregional coverage options, but microsurgical options should be a routine alternative of the treatment repertoire. In the thumb and fingers, the reconstruction depends remarkably on injury extent. Conclusions Patient factors, surgical expertise, etiology, severity and goal of reconstruction will invariably have influence on the ultimate reconstruction performed, and algorithms may significantly help the surgical planning.

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Section: Discussionmentioning

confidence: 99%

A treatment algorithm for reconstruction of soft tissue defects in the hand: a narrative review

Nordback,

Hakkarainen,

Mattila

2023

Ann Transl Med

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“…The commonly used V-Y advancement flap, crossfinger flap, fascial island flap, and abdominal flap have their own advantages, disadvantages, and indications ( 19 ). V-Y advancement flap, cross-finger flap, and fascial island flap are effective in repairing small soft tissue defects in the fingers; however, it cannot achieve a good treatment effect for a large area of degloving injury ( 20 ). Although abdominal flaps can repair large areas of skin defects, their appearance is edematous, and the skin texture is very different from finger skin.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

et al. 2022

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BackgroundTo explore the clinical effect of digital dorsal fascial island flap combined with crossfinger flap to repair distal degloving injury and sensory reconstruction.MethodsA total of 19 patients with distal fingertip degloving injuries treated with digital dorsal fascial island flap combined with crossfinger flap in our hospital from April 2018 to August 2020 were retrospectively included. Semmes–Weinstein (SW) monofilament and static two-point discrimination (S-2PD) tests, active range-of-motion (ROM) of the fingers, cold intolerance, visual analog scale (VAS) score patient complications, and patient satisfaction were evaluated.ResultsFive cases with post-operative flap blisters were treated at the time of dressing changes until successful scab formation. Three cases with post-operative arterial crisis of finger arterial dorsal branch vessel were relieved after suture removal and tension reduction. All other skin flaps and skin grafts survived. Nineteen patients received follow-up between 3 and 26 months (average 14.6 months). The active ROM of metacarpophalangeal (MCP) and interphalangeal (IP) joints of the injured fingers were satisfactory.ConclusionThe digital dorsal fascial island flap combined with the crossfinger flap for repairing the distal degloving injury of the distal segment of the finger is a good surgical method, which is simple and easy to operate, can repair a large area of soft tissue defect, and obtain a satisfactory effect.

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“…Among these methods, V-Y flaps, oblique triangular flap, rotation pulp flap, and homodigital neurovascular island flaps are probably most frequently used in oblique fingertip amputation. 10 …”

Section: Discussionmentioning

confidence: 99%

A New Triangular Rotation and Advancement Pulp Flap for Lateral Oblique Fingertip Defect

Zhou

Zhao

Zhang

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: The fingertip is one of the most common sites of traumatic injuries faced by hand surgeons. In cases of lateral oblique amputation, only limited alternatives are available for reconstruction. This study introduced a new method involving rotation and use of an advancement pulp flap for covering lateral oblique defect and evaluated its outcome. Method: A series of 12 patients with 14 lateral oblique fingertip defects were recruited in this study. All fingertips were unreplantable and were injured distal to the proximal one-third of nail bed, with phalanx exposed. All cases received surgical reconstruction using a triangular rotation and advancement pulp flap. Static 2-point discrimination, cold intolerance, pain, hypersensitivity, range of motion, and aesthetic satisfaction were evaluated 6 months to 12 months postoperation. Result: Bone defect was noted in 7 cases. The area of defect was 10×7–20×12 mm2, and the angle of defect was 30–60 degrees. Mean follow-up was 14.3 months. No hook nail deformity, cold intolerance, and hypersensitivity were observed. One patient complained about pain postoperation, demanding a second operation. Static 2-point discrimination was between 5 and 8 mm in all cases. Range of motion of distal interphalangeal joint recovered to 20–45 degrees at the last follow-up. No stiffness was observed in the interphalangeal or metacarpophalangeal joints. All patients were satisfied with the appearance of the flap. Conclusion: The triangular rotation and advancement pulp flap is simple, safe, and reliable for treating lateral oblique defect of fingertip, providing scope for anatomical reconstruction and fair sensation and aesthetic recovery.

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Treatment of defects in the tip and palmar surface of the fingers

Cited by 11 publications

References 19 publications

A treatment algorithm for reconstruction of soft tissue defects in the hand: a narrative review

A treatment algorithm for reconstruction of soft tissue defects in the hand: a narrative review

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

A New Triangular Rotation and Advancement Pulp Flap for Lateral Oblique Fingertip Defect

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