title: Bilaterally innervated dorsal digital flap for sensory reconstruction of digits.
abstract: BACKGROUND
  Providing sensory coverage in digits continues to be a challenging problem. This study reports the sensory reconstruction of digits with bilaterally innervated dorsal digital flaps and compares the results between dual- and single-innervated flaps.
  
  
  METHODS
  Over 7 years, a retrospective study was conducted with 73 patients who had soft-tissue defect of the digit treated with the bilaterally innervated dorsal digital flap. There were 73 soft-tissue defects in 73 digits. The size of the defects ranged from 1.8 to 2.7cm in length (mean, 2.2cm) and from 1.6 to 2.2cm in width (mean, 1.9cm). The bilateral dorsal branches of the digital nerves were attached with the flap for the sensory reconstruction of digits. Reconstructive techniques included the cross-finger flap in 35 cases, the dorsal digital island flap in 24 cases, and the dorsal digital free flap in 14 cases. To objectively evaluate the efficacy of the bilaterally innervated flaps, we selected a comparison group that included 42 patients treated with the single-innervated flap.
  
  
  RESULTS
  A significant difference was found between the dual- and single-innervated flaps in two-point discrimination, pain, Tinel's sign, and patient satisfaction results. By comparison, the dual-innervated flap presented better discriminatory sensation on the flap, lower incidence of pain and Tinel's sign, and a larger degree of satisfaction than the single-innervated flap. Of the dual-innervated flap group, the mean joint motion of the donor finger was similar to that of the opposite side.
  
  
  CONCLUSIONS
  The bilaterally innervated dorsal digital flap is a reliable alternative for the sensory reconstruction of digits. Performing double neurorrhaphies can improve flap sensation and reduce digital neuroma incidence when reconstructing a soft-tissue defect associated with both transected digital nerves.
authors.affiliation: The Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, PR China. Electronic address: ts_chenchao@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.affiliation: The Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, PR China. Electronic address: tangpeifubeijing@163.com.
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
authors.affiliation: Hand Surgery Department, The Second Hospital of Tangshan, Tangshan 063000, Hebei, PR China. Electronic address: ts_13717517534@126.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology* / Q000601:surgery*; D005385:Fingers / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000503:physiopathology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D014110:Touch; D016896:Treatment Outcome
keywords: Dorsal branch of the digital artery; Dorsal branch of the digital nerve; Dorsal digital flap; Soft-tissue defect