title: Functional outcome after the Moberg advancement flap in the thumb.
abstract: A Moberg palmar advancement flap was performed for pulp reconstruction of the thumb in 36 cases. No flap was lost. Eighty-three percent of the defects were closed without additional iatrogenic bony shortening of the thumb. Sensory testing showed normal sensitivity in 74% of the 25 patients studied at a mean of 27 months. Minor restrictions in the active range of motion in the interphalangeal joint were mainly attributable to a loss of hyperextension. No thumb showed a permanent flexion contracture. The flap alone did not result in a reduction in grip strength, but an additional bony amputation resulted in decreased strength of 3-point pinch grip. Seventy-two percent of the patients had no or only mild subjective complaints. The Disabilities of the Arm, Shoulder, and Hand questionnaire, which was used for the first time as a standardized measure to assess functional outcome after this procedure, showed only minor impairment levels (12.4 +/-). Based on these data, the Moberg advancement flap remains the procedure of choice for covering defects of the distal palmar thumb.
authors.affiliation: Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwig-Guttmannstrasse 13, 67071 Ludwigshafen, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Baumeister
authors.forename: Henrik
authors.initials: H
authors.lastname: Menke
authors.forename: Michael
authors.initials: M
authors.lastname: Wittemann
authors.forename: Günter
authors.initials: G
authors.lastname: Germann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D004185:Disability Evaluation; D005260:Female; D005384:Finger Joint / Q000503:physiopathology; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome