Necmi Cam, Muharrem Kanar

Department of Orthopedics and Traumatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye

Keywords: Amputation, fingertip, nail bed, reposition-flap.

Abstract

Objectives: The aim of this study was to evaluate the effectiveness of using cross finger and thenar flaps in treatment of distal fingers amputations with reposition-flap method.

Patients and methods: Between September 2017 and January 2020, a total of 20 fingers of 19 patients (15 males, 4 females; mean age: 31.6±10.4 years; range, 19 to 52 years) who were treated with repositioning using a cross finger or thenar flap were retrospectively analyzed. Finger length, flap status, pain, cold intolerance, two-point discrimination, bone healing and appearance of the nail were recorded. Functional evaluation was performed using the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) score and range of motion.

Results: The mean follow-up was 19.5±5.2 months. A poor result was seen in one patient with the development of necrosis in the flap. With the exception of one finger with necrosis in the flap, no major complications were observed. Union was achieved in all other bones. The mean shortness was 3.7±1.9 mm. The mean Quick-DASH score was 4.5±5.0 and the mean two-point discrimination test was measured as 6.8±0.9.

Conclusion: In fingertip amputations repositioning with a cross finger or thenar flap can achieve a near-normal fingertip appearance with the advantages for the surgeon of a short learning curve and no requirement for microsurgery experience. If replantation cannot be applied in fingertip amputations, this method should be considered among the treatment options, particularly for patients with high aesthetic expectations.

Citation: Cam N, Kanar M. Are cross finger and thenar flaps effective in the treatment of distal finger amputations with the reposition-flap method?. Jt Dis Relat Surg 2022;33(3):631-638.

Ethics Committee Approval

The study protocol was approved by the Şişli Hamidiye Etfal Clinical Research and Ethics Committee (date: 22.12.2020, no: 3078). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/consept, design, data collection and/processing, analysis and/or interpretation, references and fundings: N.C.; Control/supervision, literatur review, writing the article, critical, review, materials: M.K.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.