title: Reconstruction of two fingertip amputations using a double thenar flap and comparison of outcomes of surgery using a single thenar flap.
abstract: BACKGROUND
  Although thenar flap for single fingertip amputation is a common and popular surgical technique, double thenar flap technique for patients with two fingertip amputations has rarely been reported in the literature. The purpose of this case-control study was to introduce the double thenar technique and compare the clinical outcomes between single thenar flap and double thenar flap surgical treatments.
  
  
  METHODS
  From January 2005 to December 2014, 92 patients with single fingertip amputations were treated with thenar flap (Group I) and 28 patients with two fingertip amputations were treated with double thenar flap (Group II). These 120 patients were followed-up for a minimum of 12 months postoperatively. At the latest follow-up, the two groups were assessed for pain, cold intolerance in the reconstructed finger, functional outcomes by Chen's criteria, and subjective patient satisfaction.
  
  
  RESULTS
  At the final follow-up, all flaps in both groups had survived. No flap failure occurred. There was no significant difference in cold intolerance (p=0.783), donor site pain (p=0.728), fingertip pain (p=1.000), or paresthesia (p=0.514) between the two groups. A total of 100 (83.3%) patients were completely or fairly satisfied. There was no significant difference in satisfaction between the two groups (p=0.801). According to the Chen criteria, 102 (85%) patients had excellent or good results.
  
  
  CONCLUSIONS
  This study demonstrated that the double thenar flap technique used for patients with two fingertip amputations produced complete survival with functional outcomes comparable to those of the single thenar flap technique at the last follow-up.
authors.affiliation: Department of Orthopedic Surgery, Sungmin General Hospital, Incheon, Republic of Korea.
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Kwon
authors.affiliation: Department of Orthopedic Surgery, Sungmin General Hospital, Incheon, Republic of Korea.
authors.forename: Byung-Moon
authors.initials: BM
authors.lastname: Ahn
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Chung-Ang University, Seoul, Republic of Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of General Surgery, School of Medicine, Chung-Ang University, Seoul, Republic of Korea.
authors.forename: Yong-Gum
authors.initials: YG
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Chung-Ang University, Seoul, Republic of Korea.
authors.forename: Hyun-Jun
authors.initials: HJ
authors.lastname: Ryu
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Chung-Ang University, Seoul, Republic of Korea. Electronic address: hayongch@naver.com.
authors.forename: Yong-Chan
authors.initials: YC
authors.lastname: Ha
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000503:physiopathology / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000294:innervation / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult
keywords: Double thenar flap; Two fingertip amputations