title: Cross-finger flap for reconstruction of fingertip amputations: Long-term results.
abstract: Fingertip amputations are severe hand injuries. Their treatment must restore the sensation and metabolic activity needed for pain-free finger function. The cross-finger flap (CFF) can be used for this purpose. The goal of this study was to assess the long-term clinical outcome following use of this flap.
  
  
  
  This was a retrospective analysis of 28 patients operated because of fingertip amputation: 16 type 3, 8 type 2 and 4 type 4. The CFF was harvested from an adjacent finger on the dorsal side of the middle phalanx down to the epitenon. A dorsopalmar hinge was preserved to ensure vascularisation. The CFF was divided an average of 18.7 days later. The following parameters were evaluated: pulp volume (injured compared to contralateral finger), presence of neuroma, occurrence of complications (necrosis, infection, and donor site morbidity), cold discomfort, static and tactile discrimination, and patient satisfaction (0 to 10 on VAS).
  
  
  
  The average follow-up was 19.7 years; 22 patients (78.6%) were re-examined in person or contacted by telephone. The average healthy pulp to reconstructed pulp ratio was 1.03. No postoperative complications such as neuroma were found. Cold sensitivity was present in 7 patients. The flap was re-sensitised in all the patients. There was no donor site morbidity. The average patient satisfaction score was 9 (range 8-10).
  
  
  
  Over the long-term, use of the CFF results in nearly normal fingertip metabolism, no complications and good distal sensitivity without pain or neuromas. This is a simple, reliable, long-lasting reconstruction technique.
  
  
  
  IV.
authors.affiliation: Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France. Electronic address: rabarin@centredelamain.fr.
authors.forename: F
authors.initials: F
authors.lastname: Rabarin
authors.affiliation: Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Saint Cast
authors.affiliation: Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France.
authors.forename: J
authors.initials: J
authors.lastname: Jeudy
authors.affiliation: Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France.
authors.forename: P A
authors.initials: PA
authors.lastname: Fouque
authors.affiliation: Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France.
authors.forename: B
authors.initials: B
authors.lastname: Cesari
authors.affiliation: Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France.
authors.forename: N
authors.initials: N
authors.lastname: Bigorre
authors.affiliation: Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France.
authors.forename: A
authors.initials: A
authors.lastname: Petit
authors.affiliation: Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France.
authors.forename: G
authors.initials: G
authors.lastname: Raimbeau
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D002648:Child; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012677:Sensation; D020886:Somatosensory Disorders / Q000209:etiology; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cross-finger flap; Fingertip amputation; Fingertip sensitivity