Clinical trial NCT01778296: Repair of Soft Tissue Defect of the Finger Using the Heterodigital Neurocutaneous Island Flap
Official title: Repair of Soft Tissue Defect of the Finger Using the Heterodigital Neurocutaneous Island Flap
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Sensory Reconstruction of the Volar Aspect of the Finger
The Heterodigital Neurocutaneous Island Flap
Keywords: Dorsal branch of the digital nerve;
dorsal digital artery;
dorsal digital island flap;
neurocutaneous island flap.
Lead sponsor: The Second Hospital of Tangshan
Sponsor class: OTHER
Collaborators: name: Chinese PLA General Hospital
First posted: 2013-01-29
Enrollment: 12
Sex: ALL
Minimum age (years): 15
Maximum age (years): 60
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The dorsum of the finger is a reliable flap donor site in reconstructive hand surgery because of its similar quality to the original. The dorsal digital island flap can be used for repairing the defect of adjacent finger, but the limited length of the pedicle precludes its use for a more distal defect. The heterodigital neurocutaneous island flap of the dorsal branch of the digital nerve can be used as an alternative to resolve this problem.

Detailed description: At final follow-up, we measured the sensibility of the flaps using the Semmes-Weinstein monofilament test and the static 2-point discrimination test. The test points were at the center of the radial or ulnar portion of the pulp. The donor site, i.e. radial- or ulnar-dorsal aspect of the middle phalanx of the donor digit, was also evaluated. Each area was tested 3 times with a Discriminator (Ali Med, Dedham, MA). We stopped at 4mm as a limit of 2PD and considered this normal.

Eligibility criteria: Inclusion Criteria:

* the soft tissue defects involving the middle phalanx, the proximal interphalangeal joint, or both;
* a defect greater than or equal to 2 cm in length;
* a patient between 15 and 60 years of age.

Exclusion Criteria:

* concomitant injuries to the dorsal skin of the middle phalanx of adjacent finger that precluded its use as donor site;
* injuries to the course of donor nerve branch;
* a defect less than 1.5 cm in length;
* a fingertip or pulp defect;
* a soft tissue defect of the thumb.

Primary outcomes:
measure: Discriminatory Sensation of the Flap
timeFrame: 18 months to 24 months
Secondary outcomes:
measure: Cold Intolerance
timeFrame: 18 months to 24 months
Other outcomes:
Locations:
city: Tangshan
country: China
facility: The Second Hospital of Tangshan
state: Hebei
Study officials:
References:
citation: Chen C, Zhang X, Shao X, Gao S, Wang B, Liu D. Treatment of a combination of volar soft tissue and proper digital nerve defects using the dorsal digital nerve island flap. J Hand Surg Am. 2010 Oct;35(10):1655-1662.e3. doi: 10.1016/j.jhsa.2010.07.011.
citation: Wang B, Zhao Y, Lu A, Chen C. Ulnar nerve deep branch compression by a ganglion: a review of nine cases. Injury. 2014 Jul;45(7):1126-30. doi: 10.1016/j.injury.2014.03.017. Epub 2014 Apr 3.
citation: Chen C, Tang P, Zhang L. Reconstruction of a soft tissue defect in the finger using the heterodigital neurocutaneous island flap. Injury. 2013 Nov;44(11):1607-14. doi: 10.1016/j.injury.2013.06.025. Epub 2013 Jul 18.