title: Treatment of soft-tissue loss with nerve defect in the finger using the boomerang nerve flap.
abstract: BACKGROUND
  This study reports simultaneous repair of soft-tissue loss and proper digital nerve defect in the finger using a boomerang nerve flap including nerve graft from the dorsal branch of the proper digital nerve.
  
  
  METHODS
  From July of 2007 to May of 2010, the flap was used in 17 fingers in 17 patients. The injured fingers included five index, seven long, and five ring fingers. The mean soft-tissue loss was 2.5 × 1.9 cm. The mean flap size was 2.8 × 2.1 cm. Proper digital nerve defects were reconstructed using nerve graft harvested from the dorsal branch of the adjacent finger's proper digital nerve. The average nerve graft length was 2.5 cm. The comparison group included 32 patients treated using a cross-finger flap and a secondary free nerve graft.
  
  
  RESULTS
  In the study group, 15 flaps survived completely. Partial necrosis at the distal edge of the flap occurred in two cases. At a mean follow-up of 22 months, the average static two-point discrimination and Semmes-Weinstein monofilament test results on the pulp of the reconstructed finger were 7.5 mm and 3.86, respectively. In the comparison group, the results were 9.3 mm and 3.91, respectively. The study group presented better discriminatory sensation on the pulp and milder pain and cold intolerance in the reconstructed finger.
  
  
  CONCLUSIONS
  The boomerang nerve flap is useful and reliable for reconstructing complicated finger damage involving soft-tissue loss and nerve defect, especially in difficult anatomical regions.
  
  
  METHODS
  Therapeutic, II.
authors.affiliation: Tangshan and Qinhuangdao, Hebei; and Beijing, People's Republic of China From the Hand Surgery Department, the Second Hospital of Tangshan; Affiliated Hospital of North China Coal Medical College (Hebei United University); the Department of Orthopedics, General Hospital of the People's Liberation Army; the Hand Surgery Department, Second Hospital of Qinhuangdao; and Chengde Medical College.
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000294:innervation; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000601:surgery*; D010525:Peripheral Nerves / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000294:innervation* / Q000637:transplantation; D016896:Treatment Outcome