Sensory Reconstruction of Finger Pulp Defect Using a Dorsal Digital Island Flap

Sensory reconstruction of the finger pulp is a challenging problem. This article reports repair of the finger pulp defect using the dorsal digital island flap. Both dorsal branches of the proper digital nerves (PDNs) were used for maximal sensory restoration.

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Key information

Conditions

Trauma Wounds and Injuries

Age range

15 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

From February 2008 to May 2009, the flap harvested from the dorsum of the middle phalanx of the same finger was used in 12 fingers in 12 patients. The flaps ranged in size from 2.0 × 2.0 cm to 2.8 × 2.2 cm. The mean pedicle length was 1.2 cm. Neurorrhaphy between the dorsal branches of the PDN and PDN was performed in both sides in all cases. Sensibility of the reconstructed finger pulp was evaluated by static 2-point discrimination (2PD) and Semmes-Weinstein monofilament test. The range of motion of the donor fingers was measured. The data were compared to those of the opposite sides.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

a finger pulp defect > 1.5 cm in length
necessity to preserve finger length
patients younger than 60 years .

Exclusion criteria

injury to the dorsum of the middle phalanx of the reconstructed finger that precluded its use as donor site
injury to the course of the vascular pedicle or opposite PDA
defects < 1.5 cm in length.

Treatment and study plan

Sensate Dorsal Digital Island Flap

Procedure

This article reports repair of the finger pulp defect using the dorsal digital island flap. Both dorsal branches of the proper digital nerves (PDNs) were used for maximal sensory restoration.

Other names: Surgical Flap, Island Flap

Primary outcomes

static 2-point discrimination test

Time frame: Patients were followed for 16-23 months (mean, 19 months)

The patients were assessed at follow-up by an independent senior surgeon who did not attend the treatments. Evaluation included active range of motion (ROM) of the DIP and proximal interphalangeal (PIP ) joints, and static 2-point discrimination (2PD) and Semmes-Weinstein monofilament test of the reconstructed finger pulps. These measurements were compared with those on the contralateral site. According to the Michigan Hand Outcomes Questionnaire (MHQ), patients reported their satisfaction with the appearance of the injured hand. The questions based on a 5-point response scale.

Secondary outcomes

Semmes-Weinstein monofilament test

Time frame: Patients were followed for 16-23 months (mean, 19 months)

The patients were assessed at follow-up by an independent senior surgeon who did not attend the treatments. Evaluation included active range of motion (ROM) of the DIP and proximal interphalangeal (PIP ) joints, and static 2-point discrimination (2PD) and Semmes-Weinstein monofilament test of the reconstructed finger pulps. These measurements were compared with those on the contralateral site.

Sponsors and collaborators

Lead sponsor

The Second Hospital of Tangshan

Other

Collaborators

Chinese PLA General Hospital
The Second Hospital of Qinhuangdao

Registry information

Important dates

Study start: 2008
Primary completion: 2009
Study completion: 2011
First posted: Dec 6, 2011
Registry last updated: Dec 6, 2011

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed