Finger Injuries, Soft Tissue Injuries
Conditions
Keywords
defect,, dorsal branch of the digital artery,, dorsal digital flap,, dorsal metacarpal artery flap.
Brief summary
Multiple digital injuries are often complex and severe, and the commonly used local and regional flaps may not be feasible. The authors reconstruct soft tissue defects of the fingers using the dorsal digito-metacarpal flap and evaluate the efficacy of this technique.
Detailed description
At final follow-up, we measure the sensibility of the flaps using the static 2-point discrimination test. The Static 2-point discrimination test determines the minimal distance at which a subject can sense the presence of two needle. The modified American Society for Surgery of the Hand guidalines are used to stratify discriminator measurements(excellent \<6 mm, good 6-10 mm, fair 11-15 mm, poor \>15 mm). Each area is tested 3 times with a Discriminator (Ali Med, Dedham, MA). Two out of 3 correct answers are considered proof of perception before proceeding to another lower value. We stopp at 4mm as a limit of 2PD and consider this normal. The measurements are performed at a single time point at final follow up.
Interventions
PROCEDUREDorsal digito-metacarpal flap
The dorsal digito-metacarpal flap is a vascular island flap based on the dorsal digital artery and dorsal metacarpal artery. It has a longer vascular pedicle and provides tissue coverage of similar quality as that of normal glabrous skin but not sacrifice the digital artery.
Sponsors
Chinese PLA General Hospital
The Second Hospital of Tangshan
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
15 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
* the injured and adjacent fingers are unable to be used as the donor due to multiple digital injuries * a soft tissue defect \> 1.5 cm in length with exposed bone or tendon * the reverse DMA flap may not be appropriate for tissue reconstruction due to the concomitant injuries or due to the limitation of the rotation arc * a patient between 15 and 60 years of age
Exclusion criteria
* concomitant injuries involved all the finger that precluded their use as donor sites * a defect less than 1.5 cm in length * injuries to the course of the vascular pedicle
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Static 2-point discrimination test | 18 to 24months | The Static 2-point discrimination test determines the minimal distance at which a subject can sense the presence of two needle. The modified American Society for Surgery of the Hand guidalines are used to stratify discriminator measurements(excellent \<6 mm, good 6-10 mm, fair 11-15 mm, poor \>15 mm). Each area is tested 3 times with a Discriminator (Ali Med, Dedham, MA). Two out of 3 correct answers are considered proof of perception before proceeding to another lower value. We stopped at 4mm as a limit of 2PD and considered this normal. The measurements are performed at a single time point at final follow up. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction | 18 to 24 months | Patients report their satisfaction with the appearance of the flap and the donor site according to the Michigan Hand Outcomes Questionnaire that is based on a 5-point response scale. |
Countries
China
Outcome results
None listed