title: Sensory reconstruction in different regions of the digits: A review of 151 cases.
abstract: BACKGROUND
  Soft tissue defects of the digits are very common in hand trauma and can result in functional disability. The purpose of the study is to introduce the use of several modified and traditional sensate flaps to reconstruct different regions of the digits and to evaluate the efficacy of these techniques.
  
  
  METHODS
  A retrospective study was conducted with 151 patients who had soft tissue defects of the digits treated with the sensate flaps from February 2005 to March 2014. Based on different regions of the soft tissue defects, the patients in the study were divided into four groups [1]: thumb group treated with the dual-innervated and traditional kite flaps [2]; distal finger group treated with the single- and dual-innervated dorsal digital flaps [3]; proximal finger group treated with the heterodigital neurocutaneous island flap; and [4] awkward region group treated with the Litter flap. The main outcomes were static 2PD and Semmes-Weinstein monofilament scores of the flap, pain and patient satisfaction.
  
  
  RESULTS
  Significant difference was found between dual-innervated and traditional kite flaps, and between single- and dual-innervated dorsal digital flaps in static 2PD, pain and patient satisfaction (P<0.05). Double nerve repairs presented better discriminatory sensation on the flap, lower incidence of pain in the injured digit and larger satisfaction degree than single nerve repair.
  
  
  CONCLUSIONS
  Compared to single-innervated flap, dual-innervated flap exhibited better sensory recovery and lower pain incidence. Being an additional treatment option, Littler flap may be better choice for sensory coverage in some specific situations including border injuries.
authors.affiliation: Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, 063000, Hebei, PR China; Professor of Medicine, Hebei united university, Tangshan Hebei, 063000, PR China. Electronic address: ts_13717517534@126.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
authors.affiliation: Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, 063000, Hebei, PR China; Professor of Medicine, Hebei united university, Tangshan Hebei, 063000, PR China. Electronic address: wbladyp3@163.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, 063000, Hebei, PR China; Professor of Medicine, Hebei united university, Tangshan Hebei, 063000, PR China. Electronic address: zhangwenlong2000@163.com.
authors.forename: Wenlong
authors.initials: W
authors.lastname: Zhang
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; 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
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000294:innervation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000503:physiopathology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Dorsal branch of the digital nerve; Dorsal digital island flap; Kite flap; Sensory reconstruction