Evaluation of Dorsal Reverse Adipofascial Flap for Fingertip Amputation Reconstruction

Israa Ismael Abdulhussein, J. H. Fattah
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Abstract

Background & Objectives: Fingertip injuries are very frequent among hand injuries; these injuries need to be carefully addressed as it has an important role in fine motor activity and delicate sensation. The aim is to assess the outcome by using the dorsal reverse adipofascial flap in the reconstruction of fingertip amputations at the level of the nail fold. Methods: This prospective case series study was conducted in Rizgary Teaching and Rozhawa Emergency Hospital in Erbil city/Iraq from June 2018 to June 2020.Twenty patients sustained fingertip amputations at the level of the nail fold and underwent reconstruction of their fingertips using the dorsal reverse adipofascial flap. We evaluated the fingertip appearance, The function of the proximal interphalangeal joint and distal interphalangeal joint, donor site scar, and patient`s satisfaction. Results : The mean age ± SD of patients was 29.5 ± 8.5 years, the median was 28 years, and the age range was 18 -48 years. The most common injured finger was the ring (35%), Type of injury was mostly by a sharp object (40%). only one patient (5%) was not satisfied, (10) ten patients (50%) were satisfied, and 9 (45%) were highly satisfied. There was a statically significant association between patients’ satisfaction and the presence of complications. Conclusion: The dorsal reverse adipofascial flap is effective in the reconstruction of traumatic fingertip amputations at the level of the nail fold with consistent aesthetic and functional results.
背侧脂肪筋膜瓣在断指重建中的应用价值
背景与目的:指尖损伤是手部常见的损伤;这些损伤需要仔细处理,因为它在精细运动活动和微妙的感觉中起着重要作用。目的是评估使用背侧反脂肪筋膜瓣在甲襞水平重建指尖截肢的结果。方法:本前瞻性病例系列研究于2018年6月至2020年6月在伊拉克埃尔比勒市Rizgary Teaching and Rozhawa急诊医院进行。20例患者在甲襞水平处进行指尖截肢,并采用背侧脂肪筋膜瓣重建指尖。我们评估了指尖的外观,近端指间关节和远端指间关节的功能,供区疤痕和患者的满意度。结果:患者平均年龄±SD为29.5±8.5岁,中位年龄28岁,年龄范围18 ~ 48岁。最常见的手指损伤是无名指(35%),最常见的损伤类型是尖锐物体(40%)。不满意1例(5%),满意10例(50%),高度满意9例(45%)。患者满意度与并发症之间存在统计学意义上的显著关联。结论:背逆脂肪筋膜瓣在甲襞水平重建外伤性断指具有良好的美观性和功能性。
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