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Sensitivity following volar V-Y plasty for fingertip amputations
Journal of Hand Surgery (Edinburgh, Scotland)
|June 1, 1985
Summary
Volar V-Y plasty for fingertip amputations does not restore normal sensation. Most patients report reduced sensitivity and some experience hypersensitivity, particularly to cold, after this common surgical procedure.
Area of Science:
- Hand surgery
- Reconstructive surgery
- Microsurgery
Background:
- The volar V-Y plasty is a widely used surgical technique for managing transverse fingertip amputations.
- Previous assumptions suggested that fingertip sensation approaches normal levels post-procedure.
Purpose of the Study:
- To objectively evaluate the sensory outcomes in patients who underwent volar V-Y plasty for transverse fingertip amputations.
- To compare patient-reported sensation with objective sensory testing results.
Main Methods:
- A series of sixteen patients with twenty fingertip injuries treated with volar V-Y plasty were assessed.
- Sensory evaluation included patient self-assessment of sensitivity (percentage of normal), two-point discrimination, and von Frey monofilament testing.
- Results were compared to the contralateral, uninjured digit.
Main Results:
- Patients reported an average estimated sensitivity of 73% of normal.
- Objective testing revealed diminished sensation in all treated fingertips compared to the uninjured side.
- Hypersensitivity, including cryalgia (cold pain), was reported in eight patients (twelve fingertips).
Conclusions:
- Sensation in fingertips treated with volar V-Y plasty for transverse amputations is significantly impaired.
- The assumption of near-normal sensation following this procedure is not supported by clinical findings.
- Further research may be needed to explore methods for improving sensory recovery after fingertip reconstruction.