The hatchet flap for reconstruction of fingertip amputations.
BACKGROUND
Emmett has described a single triangular flap that contains a partial skin bridge on one of its sides and called it the hatchet flap. It was successfully used for defects located on various body parts. The aim of this study was to present the authors' experience and results obtained with this flap in fingertip amputations.


METHODS
Nine patients who have completed their 1-year follow-up period were included in the study. Two-point discrimination and stiffness were tested, and the patients were queried about the existence of cold intolerance, hypersensitivity, numbness, and pain in the early (3 months) and late (1 year) postoperative periods.


RESULTS
The amputations were located on the thumb in three patients, index finger in one patient, middle finger in three patients, and ring finger in two patients. The average defect size was 2.1 x 1.5 cm. Partial wound dehiscence was observed in one patient. The flap has provided good protective padding and aesthetic contour for the fingers. All incisions healed with inconspicuous scars. Average two-point discrimination was 6.3 mm (range, 4 to 8 mm). Cold intolerance was observed in two (22.2 percent) and paresthesia in one patient (11.1 percent). Joint stiffness was not noted. Most patients could return to their normal routine in approximately 4 to 5 weeks.


CONCLUSIONS
The hatchet flap is a good alternative for transverse and lateral oblique fingertip amputations and valuable for volar oblique amputations (defects <2 cm) with more extensive flap designs. The technique is simple and safe and provides good protective padding and acceptable tactile gnosis.
Tuncali
Dogan
D
Department of Plastic and Reconstructive Surgery, Ankara Education and Research Hospital, Cebeci, Ankara, Turkey. dogan_tuncali@yahoo.com
Barutcu
Ayse Yuksel
AY
Gokrem
Serdar
S
Terzioglu
Ahmet
A
Aslan
Gurcan
G
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence; D013933:Thumb / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome