title: Evaluation of moving and static two point discriminations of volar forearm skin before and after transfer as a sensate radial forearm island flap in reconstruction of degloving injury of the thumb.
abstract: In degloving injury of the thumb the large skin defect needs cover with sensate, glabrous and pliable skin. Although coverage of this defect with a sensate free flap from the foot is the best choice, most commonly, cover is achieved using a non-sensate distant pedicle flap. Between 2001 and 2003, degloving injuries of the thumb in eight patients were reconstructed using a sensate radial forearm flap in the sensory territory of the lateral ante-brachial nerve of the forearm which was repaired to the digital nerve of the thumb (six cases) or to a branch of the sensory radial nerve (two cases). Follow-up period ranged from 17 to 41 months (mean: 29.9 months). Sensory evaluation was performed using the moving two point discrimination (M-2PD) and static two point discrimination (S-2PD) of the volar forearm skin. These altered significantly after transfer and their values approached those of the contra-lateral thumb but never reached normal sensation (p<0.01). Sensate radial forearm island flap is a reliable option to cover a large defect of the thumb such as degloving injury and the sensation produced is acceptable.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hazrat Fatemeh Hospital, Iran Medical University, Tehran, Iran. fatemi41@yahoo.com
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Fatemi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jalilimanesh
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Dini
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D005542:Forearm; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome