[Pedicled flap procedures for sensory restoration of the hand: long-term results].
OBJECTIVE
We evaluated the long-term results of patients who underwent reconstruction with pedicled flaps for soft tissue and sensory restoration.


METHODS
The study included 30 patients (26 males, 4 females; mean age 33 years; range 16 to 62 years) who underwent sensory restorations of the thumb (n=24), the index finger (n=3), and the little finger (n=3). Twenty-seven patients received neurovascular island flaps and three patients received radial innervated cross-finger flaps. Disconnection-reconnection of the nerve was performed in 11 patients receiving a neurovascular island flap. Sensory evaluations were made with two-point discrimination and the Semmes-Weinstein monofilament test. The mean follow-up was 29.2 months (range 5 to 144 months).


RESULTS
There were no cases of flap loss. Contractures of donor digits were seen in four patients (14.8%) treated with neurovascular island flaps. Neuroma formation was noted in two patients (18.2%) in whom the disconnection-reconnection technique was used. Static and moving two-point discrimination test results were 9.1 mm and 7.4 mm with the disconnection-reconnection technique, 8.3 mm and 7 mm with the original technique, and 10.3 mm and 8.6 mm with radial innervated cross finger flaps, respectively. Sensation was at the recipient site in all the patients who underwent disconnection-reconnection. Of those in whom the original technique was employed, nine patients (56.3%) localized sensation at the recipient site, three patients (18.8%) at the donor site, while four patients (25%) showed double sensibility.


CONCLUSIONS
Pedicled flaps are reliable and satisfactory alternatives for soft tissue and sensory restoration of hand injuries and disconnection-reconnection of the nerve is effective in preventing double sensibility.
Ozkan
Türker
T
Istanbul Universitesi Istanbul Tip Fakültesi Plastik ve Rekonstrüktif Cerrahi Anabilim Dali.
Kabakaş
Fatih
F
Aydin
Atakan
A
Yaprak
Bülent
B
Güdemez
Eftal
E
D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012677:Sensation; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries / Q000294:innervation; D016896:Treatment Outcome