A Comparison of Dorsal Branch of the Digital Nerve Versus Dorsal Digital Nerve for Finger Pulp Reconstruction

Study Overview
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Brief Summary
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As the donor nerve attached with the flap, the dorsal branch of the digital nerve and the dorsal digital nerve is commonly used for finger pulp reconstruction.This study compares two donor nerves: the dorsal branch of the digital nerve and the dorsal digital nerve.

Detailed Description
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The investigators compares two donor nerves attached with the flap for sensory reconstruction of finger pulp: the dorsal branch of the digital nerve and the dorsal digital nerve. The main outcomes were static 2-point discrimination and Semmes-Weinstein monofilament scores of the flap, and pain and cold intorlence of the reconstructed finger.

Conditions
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Soft Tissue Defect of the Finger

Intervention / Treatment
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* Procedure: flap includes a donor nerve


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The pulp or fingertip defect in only one finger A defect greater than or equal to 1.5 cm in length Necessity to preserve finger length A patient between 18 and 60 years of age Exclusion Criteria: Injuries to the dorsum of the middle phalanx Injuries to the course of the vascular pedicle or donor nerve A defect less than 1.5 cm in length Multiple finger pulp defect Extremely contaminated wounds

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Innervated finger flap<br>donor nerve attached with the flap for finger pulp reconstruction | Procedure: flap includes a donor nerve<br>* the donor nerve is attached with the flap for sensory reconstruction of the finger<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| static 2-point discrimination (2PD) test | The test points are at the center of the radial or ulnar portion of the pulp. Each area is tested 3 times with a Discriminator. We stop at 4mm as a limit of 2PD and consider this normal. | 18 months to 26 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cold intolerance | Cold intolerance in the reconstructed finger is assessed using the self-administered Cold Intolerance Severity Score questionnaire [10]. The maximum score is 100 and was group into 4 ranges (0-25, 26-50, 51-75, and 76-100), corresponding to mild, moderate, severe, and extreme severity, respectively. | 18 months to 26 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dorsal digital nerve, dorsal branch of the digital nerve, dorsal branch of the digital artery, dorsal digital island flap, finger pulp defect.