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[Qualitative retrospective study comparing 43 advanced-rotated flaps to 19 island type Venkataswami-Subramanian
1Service de chirurgie plastique, CH Saint-Luc-Saint-Joseph, Lyon, France.
Objective:
In case of a fingertip trauma, the surgeon'aim is to give the finger a good function, that means a fingertip with good sensibility and trophicity. The purpose of this study was to follow-up three different types of flaps used for fingertip reconstruction, and to analyse their sensibility and functional results.
Method:
62 fingertip-flaps performed in 60 patients were included in this series. Patients were mainly males (45-60), adults (42-60), middle age (mean age = 40), right-handed (55-60) and home-injured (32-60). The dominant side was injured more often (43-60), by section (27-60) or crush (25-60). Patients were reviewed by the same investigator. Various types of flaps were used: 31 Atasoy flaps, 19 neurovascular island unipedicled flaps and 12 Hueston flaps. Sensory results were evaluated using static and moving two-point discrimination tests, and pain and hot-cold discrimination. Esthetic and functional results were also evaluated.
Results:
The tactile sensibility was good or excellent in 63% of flaps and the nail looked good in 70% of flaps. Among all flaps, the Atasoy flap obtained the best results.
Discussion:
This study showed the good quality of Atasoy and Hueston flaps in fingertip reconstruction. Neurovascular island flaps gave poor results without taking in account the severity of initial trauma.