Purpose
Modified heterodigital neurovascular island flaps and free lateral great toe flaps
are dependable methods for treating thumb-tip defects with phalangeal bone exposure.
We retrospectively analyzed and compared the details and results of the two methods.
Methods
This retrospective study included 25 patients with thumb injuries with phalangeal
bone exposure treated between 2018 and 2021. Patients were categorized as per the
following surgical methods: (1) modified heterodigital neurovascular island flap (12
patients, finger flap group) and (2) free lateral great toe flap (13 patients, toe
flap group). The Michigan Hand Outcome Questionnaire, aesthetic appearance, Vancouver
Scar Scale, Cold Intolerance Severity Score, static 2-point discrimination, Semmes-Weinstein
monofilament, and range of motion of the metacarpophalangeal joint of the injured
thumb were evaluated and compared. In addition, operation time, hospital stay, return-to-work
time, and complications were recorded and compared.
Results
In both groups, the defect was successfully repaired, with no cases of complete necrosis.
The 2 groups had similar mean scores in static 2-point discrimination, Semmes-Weinstein
monofilament, range of motion, and Michigan Hand Outcome Questionnaire scores. The
aesthetic appearance, scarring, and cold tolerance of the toe flap group were better
than the finger flap group. The operation time, hospital stay, and return-to-work
time in the finger flap group were shorter than the toe flap group. The finger flap
group had 2 complications—a superficial infection and 1 case of partial flap necrosis.
The toe flap group had 3 complications—a superficial infection, 1 case each of partial
flap necrosis, and partial skin graft loss.
Conclusion
Both treatments can achieve satisfactory results; however, they each have advantages
and disadvantages.
Type of study/level of evidence
Therapeutic IV.
Keywords
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Article info
Publication history
Published online: February 17, 2023
Accepted:
December 13,
2022
Received:
June 30,
2022
Publication stage
In Press Corrected ProofFootnotes
Y.W. and Q.Z. contributed equally to this work.
No benefits in any form have been received or will be received related directly to this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
