Repair of Multiple Finger Defects Using the Dorsal Homodigital Island Flaps

Study Overview
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Brief Summary
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Multiple finger defects are common in hand trauma and result in functional disability. These injuries are often complex and severe, and thus reconstructive alternatives are limited. In this study, we use the dorsal homodigital island flaps, based on the dorsal branch of the digital artery, for reconstruction of multiple finger defects. At the final follow-up, we would evaluate the efficacy of this technique.

Detailed Description
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At final follow-up, sensation of the flap and the donor site would be assessed using static two-point discrimination and Semmes-Weinstein monofilament testing. The range of motion of the proximal interphalangeal joint and the distal interphalangeal joint of the injured finger is measured by a goniometer. The cold intolerance of the injured finger is measured using the self-administered Cold Intolerance Severity Score questionnaire that is rated into mild, moderate, severe, and extreme. The pain of the injured finger and the donor site is given subjectively by the patient using the visual analogue scale, which ranges from 0 to 10 cm and groupes into mild (0-3 cm), moderate (4-6 cm) and severe (7-10 cm).

Official Title
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Repair of Multiple Finger Defects Using the Dorsal Homodigital Island Flaps

Conditions
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Finger Injuries, Soft Tissue Injuries

Intervention / Treatment
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* Procedure: Soft tissue coverage


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a patient who had separate soft tissue defects in different fingers in same hand; the defect ≥ 1.5 cm and ≤ 3.5 cm in length; local tissue near the defect is uninjured; and a patient between 15 and 60 years of age. Exclusion Criteria: concomitant injuries to local tissue around the defect that precluded its use as donor site; a defect < 1.5 cm and ≥ 3.5 cm in length; a finger degloving injury; the defect of the thumb.

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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Accepts Healthy Volunteers

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Surgical flap<br>Surgical flap is based on the dorsal branch of the digital artery, and is used for soft tissue coverageof multiple finger defects. | Procedure: Soft tissue coverage<br>* The dorsal homodigital island flaps are used for soft tissue coverage of multiple finger defects<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| static two-point discrimination | The test points are at the center of the flap.Each area is tested 3 times with a Discriminator. We stopp at 4 mm as a limit of two-point discrimination and consider this normal. | postoperative 18-24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cold intolerance of the injured finger | The cold intolerance of the injured finger was measured using the self-administered Cold Intolerance Severity Score questionnaire that was rated into mild, moderate, severe, and extreme. | Postoperative 18-24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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surgical flap;, dorsal branch of the digital artery