title: Thumb Tip Defect Reconstruction Using Neurovascular Island Pedicle Flap Obtained From Long Finger.
abstract: BACKGROUND
  Thumb tip reconstruction has been a very challenging issue for hand surgeons. Varieties of reconstructive options have been described or modified to obtain satisfactory sensory recovery. However, none has yielded entirely satisfactory results. This study reports a retrospective review of clinical data records of patients treated with a neurovascular island pedicle flap obtained from the medial aspect of the long finger.
  
  
  METHODS
  We enrolled 15 patients (9 men and 6 women), who received neurovascular island pedicle flaps for thumb tip amputations between December 2011 and December 2015. The average size of the flap was 2.8 × 2.2 cm(2) (range 2.5 × 1.8 cm(2) to 3.5 × 2.5 cm(2)). At the final follow-up visits, static two-point discrimination, visual analogue scale, Michigan hand outcome questionnaire and return-to-work time were used to evaluate surgical outcomes.
  
  
  RESULTS
  All flaps survived well. The follow-up period was 18 months. The mean static 2PD values at the reconstructed thumb tip and donor finger pulp (medial side) were 5.3 mm (range 4-8 mm) and 3.2 mm (range 3-4 mm), respectively. The average VAS scores for the aesthetic appearance of the donor site and recipient site were 9.1 (range 8-10) and 9.0 (range 8-9.5), respectively. The average Michigan Hand Outcome Questionnaire (MHOQ) score for hand function (reconstructed hand) was 8.2 (range 6-16). The average RTW time was 8.4 weeks (range 7-12 weeks).
  
  
  CONCLUSIONS
  Neurovascular island pedicle flap obtained from the medial aspect of long finger is a very reliable alternative technique for thumb tip defect reconstruction.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Hand and Foot Surgery, Rui Hua Hospital, Affiliated hospital of Suzhou University, 5 Tayun Road, Yuexi Town, Wuzhong District, Suzhou, 215104, Jiangsu, People's Republic of China.|Department of Hand and Foot surgery, Subei People's Hospital, Affiliated hospital of Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.
authors.forename: Hongjun
authors.initials: H
authors.lastname: Liu
authors.affiliation: College of Medicine, Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.
authors.forename: Subhash
authors.initials: S
authors.lastname: Regmi
authors.affiliation: Department of Hand and Foot surgery, Subei People's Hospital, Affiliated hospital of Yangzhou University, Yangzhou, Jiangsu, People's Republic of China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Hand and Foot Surgery, Rui Hua Hospital, Affiliated hospital of Suzhou University, 5 Tayun Road, Yuexi Town, Wuzhong District, Suzhou, 215104, Jiangsu, People's Republic of China. 19445142@qq.com.
authors.forename: Ruixing
authors.initials: R
authors.lastname: Hou
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery; D016063:Blood Loss, Surgical / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000637:transplantation*; D013933:Thumb / Q000293:injuries / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
keywords: Amputations; Finger injuries; Reconstructive procedure; Soft-tissue defects; Surgical flaps; Thumb