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Repositioning and flap placement in fingertip injuries
1Department of Plastic Surgery, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
Annals of Plastic Surgery
|January 5, 2002
Summary
Local flaps with repositioned segments offer a viable surgical solution for distal finger amputations when microvascular repair is not possible. This technique successfully restores digit length, sensation, and function, improving patient outcomes.
Area of Science:
- Hand surgery
- Microsurgery
- Reconstructive surgery
Background:
- Replantation is ideal for finger amputations, but challenging for distal injuries.
- Microvascular repair is often not feasible for distal amputations.
- Alternative methods are needed to restore function and length in distal fingertip amputations.
Purpose of the Study:
- To evaluate the efficacy of repositioning amputated fingertip segments with local flaps.
- To assess functional and aesthetic outcomes of this surgical technique.
Main Methods:
- 30 patients with distal-to-distal interphalangeal joint fingertip amputations underwent repositioning with local flaps (homodigital unipedicle island flap or Tranquilli-Leali flap).
- Procedures were performed between 1994 and 1998.
- Outcomes were assessed over a 24-month follow-up period, evaluating joint mobility, nail aesthetics, function, and sensitivity.
Main Results:
- Satisfactory mobility was achieved in most cases, with only two experiencing a 20-degree extension deficit.
- Digit length was preserved, and nail aesthetics remained largely unchanged.
- Two-point discrimination averaged 7-9 mm, with 7 patients reporting cold intolerance.
Conclusions:
- Repositioning amputated segments with local flaps is a valuable surgical alternative for distal finger amputations.
- This technique effectively preserves digit length and sensitive digital pinch.
- It provides a good option when microvascular repair is not feasible.