Innervated boomerang flap for finger pulp reconstruction

Area of Science:

• Hand surgery
• Microsurgery
• Reconstructive surgery

Background:

• Finger pulp defects pose reconstructive challenges.
• Innervated flaps are crucial for restoring sensation.
• Existing methods may have limitations in providing sensation and preserving vascular supply.

Purpose of the Study:

• To evaluate the efficacy of the boomerang flap for sensory-innervated finger pulp reconstruction.
• To assess the functional outcomes, specifically two-point discrimination, following flap transfer.

Main Methods:

• The boomerang flap, incorporating dorsal sensory branches of digital nerves, was designed and transferred.
• Epineural neurorrhaphies were performed between the flap's sensory nerves and the recipient digital nerves.
• Five patients with major pulp defects underwent this one-stage reconstruction.

Main Results:

• All five patients achieved measurable two-point discrimination after a follow-up exceeding one year.
• The boomerang flap successfully preserved the proper palmar digital artery.
• The flap provided an extended and innervated skin paddle for reconstruction.

Conclusions:

• The sensory boomerang flap is a viable option for one-stage reconstruction of major finger pulp defects.
• This technique effectively restores sensation, evidenced by improved two-point discrimination.
• It offers an alternative with advantages in preserving vascularity and providing an innervated tissue source.