Sensory Reconstruction of Finger Pulp Defect Using a Dorsal Digital Island Flap

Study Overview
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Brief Summary
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Sensory reconstruction of the finger pulp is a challenging problem. This article reports repair of the finger pulp defect using the dorsal digital island flap. Both dorsal branches of the proper digital nerves (PDNs) were used for maximal sensory restoration.

Detailed Description
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From February 2008 to May 2009, the flap harvested from the dorsum of the middle phalanx of the same finger was used in 12 fingers in 12 patients. The flaps ranged in size from 2.0 × 2.0 cm to 2.8 × 2.2 cm. The mean pedicle length was 1.2 cm. Neurorrhaphy between the dorsal branches of the PDN and PDN was performed in both sides in all cases. Sensibility of the reconstructed finger pulp was evaluated by static 2-point discrimination (2PD) and Semmes-Weinstein monofilament test. The range of motion of the donor fingers was measured. The data were compared to those of the opposite sides.

Official Title
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Sensory Reconstruction of Finger Pulp Defect Using a Dorsal Digital Island Flap

Conditions
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Trauma

Intervention / Treatment
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* Procedure: Sensate Dorsal Digital Island Flap


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a finger pulp defect > 1.5 cm in length necessity to preserve finger length patients younger than 60 years . Exclusion Criteria: injury to the dorsum of the middle phalanx of the reconstructed finger that precluded its use as donor site injury to the course of the vascular pedicle or opposite PDA defects < 1.5 cm in length.

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Sensate Dorsal Digital Island Flap|This article reports repair of the finger pulp defect using the dorsal digital island flap. Both dorsal branches of the proper digital nerves (PDNs) were used for maximal sensory restoration.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| static 2-point discrimination test | The patients were assessed at follow-up by an independent senior surgeon who did not attend the treatments. Evaluation included active range of motion (ROM) of the DIP and proximal interphalangeal (PIP ) joints, and static 2-point discrimination (2PD) and Semmes-Weinstein monofilament test of the reconstructed finger pulps. These measurements were compared with those on the contralateral site. According to the Michigan Hand Outcomes Questionnaire (MHQ), patients reported their satisfaction with the appearance of the injured hand. The questions based on a 5-point response scale. | Patients were followed for 16-23 months (mean, 19 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Semmes-Weinstein monofilament test | The patients were assessed at follow-up by an independent senior surgeon who did not attend the treatments. Evaluation included active range of motion (ROM) of the DIP and proximal interphalangeal (PIP ) joints, and static 2-point discrimination (2PD) and Semmes-Weinstein monofilament test of the reconstructed finger pulps. These measurements were compared with those on the contralateral site. | Patients were followed for 16-23 months (mean, 19 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Finger pulp reconstruction, dorsal branch, proper digital nerve, palmar arterial arch, dorsal digital island flap