FINGERTIP RECONSTRUCTION WITH THE "SHARK MOUTH" INCISION THENAR FLAP: ANALYSIS OF OUTCOMES IN PEDIATRIC PATIENTS

The thenar flap technique is a time-tested method of fingertip reconstruction that has been criticized due to possible finger flexion contractures and unsightly donor site scars. Functional outcome data on thenar flaps on the pediatric population is poor in the medical literature.

In this retrospective chart review we acquired information from sixteen patients who underwent a "Shark Bite" incision thenar flap reconstruction.

Patients ranged in age from 0-17 years. Time to division ranged from 16-30 days. All 16 patients' affected finger ROM were measured in DIP, PIP and MCP joints and compared with corresponding finger on contralateral hand. A questionnaire measured subjective satisfaction in: sensibility, appearance, and function. Fingertip sensation was preserved in both affected finger and donor site. The most persistent patient complaint involved fingertip contour, were most patients rated it as "Fair"(43%) and "Good" (56%). After statistical analysis of the data we found no statistical difference in range of motion (ROM) between affected finger and the same finger on the contralateral hand on both PIP and MCP joints (p=0.08, 0.06 respectively).

The "Shark Mouth" incision thenar flap is an effective strategy for fingertip reconstruction. The results demonstrate this technique has excellent functional and aesthetic results and is not associated with flexion contractures, excessive sensibility or pain in the pediatric population.