Direct and Reversed Dorsal Digito-metacarpal Flaps: A Review of 24 Cases

The Second Hospital of Tangshan

Status: Completed

Conditions: Finger Injuries; Soft Tissue Injuries

Treatments: Procedure: Dorsal digito-metacarpal flap

Study type: Interventional

Funder types: Other

Identifiers

NCT01927003

HBTS1308112

CHS130-00215 (Other Identifier)

Details and patient eligibility

About

Multiple digital injuries are often complex and severe, and the commonly used local and regional flaps may not be feasible. The authors reconstruct soft tissue defects of the fingers using the dorsal digito-metacarpal flap and evaluate the efficacy of this technique.

Full description

At final follow-up, we measure the sensibility of the flaps using the static 2-point discrimination test. The Static 2-point discrimination test determines the minimal distance at which a subject can sense the presence of two needle. The modified American Society for Surgery of the Hand guidalines are used to stratify discriminator measurements(excellent <6 mm, good 6-10 mm, fair 11-15 mm, poor >15 mm). Each area is tested 3 times with a Discriminator (Ali Med, Dedham, MA). Two out of 3 correct answers are considered proof of perception before proceeding to another lower value. We stopp at 4mm as a limit of 2PD and consider this normal. The measurements are performed at a single time point at final follow up.

Enrollment: 24 patients

Sex: All

Ages: 15 to 55 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• the injured and adjacent fingers are unable to be used as the donor due to multiple digital injuries
• a soft tissue defect > 1.5 cm in length with exposed bone or tendon
• the reverse DMA flap may not be appropriate for tissue reconstruction due to the concomitant injuries or due to the limitation of the rotation arc
• a patient between 15 and 60 years of age

Exclusion criteria

• concomitant injuries involved all the finger that precluded their use as donor sites
• a defect less than 1.5 cm in length
• injuries to the course of the vascular pedicle

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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24 participants in 1 patient group

Surgical flap

Experimental group

Description:

Dorsal digito-metacarpal flap is based on the dorsal digital artery and dorsal metacarpal artery.

Treatment:

Procedure: Dorsal digito-metacarpal flap