[Functional results of homodigital pedicle island flaps for finger-pulp defects. Evaluation of 15 cases].

OBJECTIVES

Fingertip amputations are very common. The aim of the treatment is to restore the sensibility of the finger pulp, with adequate pulp padding. The homodigital pedicle island flaps are used in zone 2 or 3 of Allen's classification. This study evaluates the functional results of this type of flap.

METHODS

Fifteen patients were reviewed. The clinical evaluation noted complications, satisfaction level, use of the finger, cold intolerance and increased sensibility signs. The Weber test and the Semmes monofilaments were used for sensory evaluation. The joint mobility was measured and the Quick-DASH score calculated.

RESULTS

The mean time between surgery and the revision was 21 months. The average flap advancement was 12 mm. Six of the patients were very satisfied. The finger use was normal in seven cases, and excluded in only one. The average Quick-DASH was 18.18. Sixty percent of the nails were deformed, 20% were hooked. Eight patients experienced cold intolerance, and five had increased local sensibility. The average Weber score was 7 mm and the monofilaments were at 3.61. The flexion of the joint was limited in six cases.

CONCLUSION

For specific indications in finger-pulp amputation, the homodigital pedicle island flaps give satisfying aesthetic and functional results, allowing considerable advancement. Nevertheless, they are often a source of cold intolerance, finger joint stiffness and require long healing periods.