title: "Reposition-flap": A therapeutic alternative in fingertips amputations.
abstract: After trans-phalanx fingertips amputations, there is usually a therapeutic problem related to the distal fragment quality. Replantation is not always possible. The aim of this study was to propose the "reposition-flap" surgical procedure as an alternative solution to various surgical strategies for distal stump coverage. It consisted in the association of a bone fragment osteosyntesis and a pedicular local flap implementation. Between 2001 and 2011, the reposition-flap surgical procedure was retrospectively tested in two hand trauma centers. We reviewed a cohort of 51 patients divided in two groups. The first one (20 patients) was the "reposition-flap" group, the second (31 patients) had a coverage with an other surgical procedure (simple regularisation or local flap). Sensibility, pulp trophicity, fingers mobility, digital length, nail appearance and radiologic consolidation of each patient were reviewed. "Reposition-flap" allowed 80% length of phalanx conservation. In comparison with regularisation, the aesthetic aspects of the nail's finger (no claw) were improved with this surgical procedure. However, the Quick DASH average revealed significant statistical differences instead of the statistics obtained with the mobility of the IPD and the sensitivity of the pulp. This procedure gave best aesthetic and functional results.
authors.affiliation: Hand surgery unit, Saint-Antoine hospital, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France. Electronic address: drnicolasrobert@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Robert
authors.affiliation: Hand surgery unit, West Parisian private hospital, rue Castiglione-Del-Lago, 78190 Trappes, France.
authors.forename: R
authors.initials: R
authors.lastname: Chassat
authors.affiliation: Hand surgery unit, West Parisian private hospital, rue Castiglione-Del-Lago, 78190 Trappes, France.
authors.forename: C
authors.initials: C
authors.lastname: Couturier
authors.affiliation: Hand surgery unit, West Parisian private hospital, rue Castiglione-Del-Lago, 78190 Trappes, France.
authors.forename: X
authors.initials: X
authors.lastname: Delpit
authors.affiliation: Hand and nerve surgery unit, Georges-Pompidou European hospital, 20, rue Leblanc, 75015 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Masmejean
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000672:Amputation Stumps / Q000601:surgery*; D000673:Amputation, Traumatic / Q000601:surgery*; D004185:Disability Evaluation; D004954:Esthetics; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult
keywords: Amputation digitale distale; Déformation unguéale; Fingertips amputations; Nail deformation; Regularisation; Replantation; Reposition-flap; Repositionnement-lambeau; Régularisation; Réimplantation