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CC BY-NC 4.0 · Arch Plast Surg 2012; 39(06): 637-642
DOI: 10.5999/aps.2012.39.6.637
Original Article

Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip

Nae-Ho Lee
Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, Korea
,
Woo-Sik Pae
Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, Korea
,
Si-Gyun Roh
Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, Korea
,
Kwang-Jin Oh
Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, Korea
,
Chung-Sang Bae
Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, Korea
,
Kyung-Moo Yang
Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, Korea
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Background Fingertip injuries involving subtotal or total loss of the digital pulp are common types of hand injuries and require reconstruction that is able to provide stable padding and sensory recovery. There are various techniques used for reconstruction of fingertip injuries, but the most effective method is functionally and aesthetically controversial. Despite some disadvantages, cross-finger pulp flap is a relatively simple procedure without significant complications or requiring special techniques.

Methods This study included 90 patients with fingertip defects who underwent cross-finger pulp flap between September 1998 and March 2010. In 69 cases, neurorrhaphy was performed between the pulp branch from the proper digital nerve and the recipient's sensory nerve for good sensibility of the injured fingertip. In order to evaluate the outcome of our surgical method, we observed two-point discrimination in the early (3 months) and late (12 to 40 months) postoperative periods.

Results Most of the cases had cosmetically and functionally acceptable outcomes. The average defect size was 1.7×1.5 cm. Sensory return began 3 months after flap application. The two-point discrimination was measured at 4.6 mm (range, 3 to 6 mm) in our method and 7.2 mm (range, 4 to 9 mm) in non-innervated cross-finger pulp flaps.

Conclusions The innervated cross-finger pulp flap is a safe and reliable procedure for lateral oblique, volar oblique, and transverse fingertip amputations. Our procedure is simple to perform under local anesthesia, and is able to provide both mechanical stability and sensory recovery. We recommend this method for reconstruction of fingertip injuries.

Keywords

Finger injuries - Subcutaneous tissue - Microsurgery - Nerve transfer

This paper was supported by research funds from Research Institute of Clinical Medicine of Chonbuk National University in 2008.




Publication History

Received: 26 August 2012

Accepted: 27 September 2012

Article published online:
01 May 2022

© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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