Sensory Restoration, Soft Tissue Reconstruction
Conditions
Keywords
defect, dorsal branch of the proper digital nerve, dorsal digital island flap, sensory reconstruction.
Brief summary
Reconstruction of soft tissue defects in the fingers continues to be a challenge problem. The study reports reconstruction of small to moderate defects of the fingers with the direct and reversed dorsal digital island flaps and evaluates the results of the use of the flaps.The main outcomes are static 2-point discrimination and Semmes-Weinstein monofilament scores of the flap and joint motion.
Detailed description
At final follow-up, sensory restoration of the flap is measured using the static 2-point discrimination (2PD) test and Semmes-Weinstein monofilament (SWM) test. Active motion of the joints is measured using a standard hand goniometer. For the direct DDIF, total active motion is calculated as the sum of degrees of active flexion of the interphalangeal and the metacarpophalangeal joints subtracted from the degrees of extension deficit. For the reversed DDIF, total active motion of the donor finger is calculated as the sum of degrees of active flexion of the proximal and distal interphalangeal joints subtracted from the degrees of extension deficit.
Interventions
PROCEDUREDirect and reversed dorsal digital island flap
The direct dorsal digital island flap is used to cover the defects of adjacent fingers. The reversed dorsal digital island flap is used to cover the defects of the same fingers.
Sponsors
The Second Hospital of Tangshan
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
15 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* a defect greater than or equal to 1.5 cm in length * the defects on the dorsal and lateral aspects of the fingers * the defects located between the distal 1/2 of the middle phalanx and the tip of the finger * a patient between 15 and 60 years of age.
Exclusion criteria
* injuries involving the donor sites or the course of the vascular pedicle * a defect less than 1.5 cm in length.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Static 2-point discrimination test | 16 to 24 months | The test points are at the center of the flap. Each area is tested 3 times with a Discriminator (Ali Med, Dedham, MA). We stop at 4mm as a limit of static 2-point discrimination test and consider this normal. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total active motion | 16-24 months | Active motion of the joints is measured using a standard hand goniometer. For the direct DDIF, total active motion is calculated as the sum of degrees of active flexion of the interphalangeal and the metacarpophalangeal joints subtracted from the degrees of extension deficit. For the reversed DDIF, TAM of the donor finger is calculated as the sum of degrees of active flexion of the proximal and distal interphalangeal joints subtracted from the degrees of extension deficit. |
Countries
China
Outcome results
None listed