Reverse Dorsoradial Flaps for Thumb Coverage Show Increased Sensory Recovery with Smaller Flap Sizes

Abstract

Background Reverse homodigital dorsoradial (RHD) flap has been developed to repair soft-tissue defects of the thumb. However, few articles have reported this flap with long-term follow-up. This retrospective study was designed to evaluate the RHD flap and investigate factors affecting sensory recovery.

Methods From February 2010 to February 2011, 19 patients were treated consecutively with RHD flap without neurorrhaphy. At final follow-up, flap sensibility was assessed by Semmes–Weinstein (SW) monofilament, moving two-point discrimination (M-2PD), and static two-point discrimination (S-2PD) tests. Patient satisfaction, active range-of-motion of the joints, patient complications, and cold intolerance severity score questionnaire were sequentially evaluated. The patients were divided into two groups based on the S-2PD results and another two groups based on flap size.

Results The mean SW monofilament sensitivity and M-2PD and S-2PD scores on the flap were 4.01 g and 9.26 mm, and 10.63 mm, respectively. Highly positive correlations existed between the flap size and the M-2PD and S-2PD scores. Moreover, in the respective groups based on S-2PD scores and flap size, no statistical difference was found among age, sex, and follow-up time, but the flap size and S-2PD scores were statistically different.

Conclusions RHD flap without neurorrhaphy is a recommendable technique for relatively small-sized thumb-defect reconstruction, which can achieve a satisfactory sensory recovery.

Keywords

thumb - soft-tissue defect - reverse homodigital dorsoradial flap - neurorrhaphy

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