Thenar Flap: A Workhorse Flap for Fingertip Injuries

Area of Science:

• Hand surgery
• Plastic surgery
• Trauma reconstruction

Background:

• Fingertip injuries are common upper limb trauma, often resulting in volar defects.
• The thenar flap, a reconstructive option since 1926, is suitable for index, middle, and ring finger injuries.
• Surgical refinements have improved outcomes despite historical concerns about joint stiffness.

Purpose of the Study:

• To evaluate the efficacy of tailored thenar flap techniques for traumatic fingertip injuries.
• To assess functional recovery, aesthetic results, and patient satisfaction post-reconstruction.

Main Methods:

• Retrospective study of 25 patients with fingertip injuries undergoing thenar flap reconstruction.
• Assessment of range of motion (ROM) at MCPJ and PIPJ, and static two-point discrimination (2PD).
• Evaluation of aesthetic and subjective satisfaction using a Likert scale over 6-month follow-up.

Main Results:

• All flaps survived with minimal complications in 25 patients (76% male, median age 25).
• High mean ROM (MCPJ 99.92°, PIPJ 95.36°) and acceptable 2PD (5.49 mm) were achieved.
• 88% of patients reported high aesthetic satisfaction; only one case of contracture due to noncompliance.

Conclusions:

• The thenar flap is a versatile, safe, and effective method for fingertip reconstruction.
• Proper technique and rehabilitation lead to excellent functional and aesthetic outcomes.
• This technique is valuable for reconstructing fingertip defects across different age groups.