Treatment of Soft Tissue Loss With Nerve Defect in the Finger Using the Boomerang Nerve Flap

Study Overview
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Brief Summary
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Soft tissue loss with proper digital nerve (PDN) defect in the finger results in sensory loss of the finger pulp. Reconstruction of these complex soft tissue defects continues to be a challenge problem. To resolve this problem, we combined the nerve branch with the boomerang flap for simultaneous repair of soft tissue loss and PDN defect in these awkward areas. For comparison, we also collected a consecutive series of 32 patients with similar injury in the finger treated using a cross finger flap and a secondary free nerve graft.

Detailed Description
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The patients in this study group were required to meet all of the following criteria: soft tissue loss between the midpoint of the distal phalanx and PIP joint; associated PDN defect 1 to 4 cm in length; single or double PDN defects; and simultaneous repair of soft tissue loss and PDN defect. Patients were excluded when they had the following: injury to the course of the vascular pedicle or the donor site or the donor nerve; PDN defect less than 1 cm or larger than 4 cm in length; direct PDN repair; and thumb neurocutaneous defects.

Conditions
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Soft Tissue Loss With Nerve Defect

Intervention / Treatment
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* Procedure: the Boomerang Nerve Flap


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: soft tissue loss between the midpoint of the distal phalanx and PIP joint; - associated PDN defect 1 to 4 cm in length; single or double PDN defects; simultaneous repair of soft tissue loss and PDN defect. Exclusion Criteria: injury to the course of the vascular pedicle or the donor nerve; PDN defect less than 1 cm or larger than 4 cm in length; direct PDN repair; thumb neurocutaneous defects.

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 50 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

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: vascularized nerve graft<br>The investigators combined the nerve branch with the boomerang flap for simultaneous repair of soft tissue loss and PDN defect in these awkward areas. | Procedure: the Boomerang Nerve Flap<br>* The nerve branch was combined with the boomerang flap for simultaneous repair of soft tissue loss and PDN defect in these awkward areas.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| static 2-point discrimination test | The test points were at the centers of the radial and ulnar portions of the finger pulp, the flap and the donor sites separately. | from 18 to 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cold Intolerance Severity Score (CISS) questionnaire | The maximum score was 100 and was grouped into mild (0-25), moderate (26-50), severe (51-75) and extreme severity (76-100). | from 18 to 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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defect;, dorsal branch of the proper digital nerve;, proper digital nerve;, vascularized nerve graft