Outcomes of antegrade homodigital neurovascular island flap in fingertip amputations

IF 1.5 4区 医学 Q3 ORTHOPEDICS
{"title":"Outcomes of antegrade homodigital neurovascular island flap in fingertip amputations","authors":"","doi":"10.1016/j.jos.2023.08.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Antegrade homodigital neurovascular island flap (AHIF) is one of the methods used in fingertip amputations to cover the defect area, preserve finger length and obtain a painless and sensitive fingertip. The aim of this study was to evaluate the functional and sensory outcomes in patients who underwent AHIF for fingertip amputation and to analyze the relationship between patient satisfaction and outcome measures.</p></div><div><h3>Methods</h3><p>Twenty patients with a mean age of 37 (18–63) years were analyzed retrospectively. The patients were evaluated in terms of hook nail development, active interphalangeal joint<span> movements, cold intolerance, and sensory function of the flap covered area. Static two-point discrimination test and Semmes Weinstein monofilament test were performed for sensory evaluation.</span></p></div><div><h3>Results</h3><p>All flaps survived completely at the end of follow-up (mean, 36 months; range 11–64 months). Five patients had cold intolerance and two had hook nails. In total, proximal interphalangeal or distal interphalangeal joint flexion contracture developed in 25 % of the patients. The mean static two-point discrimination score was 4.6 ± 1.6 (2–8) and Semmes–Weinstein monofilament test score was 3.48 ± 0.6 (2.44–4.17). Subjective satisfaction levels of the patients were found to be high and did not show a statistical relationship with the measured clinical outcome parameters (p &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>Since AHIF contains a solid and continuous neurovascular pedicle, the probability of necrosis and loss of sensation is low in AHIF. In addition, the graft need of the donor area is not high. Its disadvantage is the rate of restriction of joint movements.</p></div><div><h3>Level of evidence</h3><p>IV.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Science","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0949265823002518","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Antegrade homodigital neurovascular island flap (AHIF) is one of the methods used in fingertip amputations to cover the defect area, preserve finger length and obtain a painless and sensitive fingertip. The aim of this study was to evaluate the functional and sensory outcomes in patients who underwent AHIF for fingertip amputation and to analyze the relationship between patient satisfaction and outcome measures.

Methods

Twenty patients with a mean age of 37 (18–63) years were analyzed retrospectively. The patients were evaluated in terms of hook nail development, active interphalangeal joint movements, cold intolerance, and sensory function of the flap covered area. Static two-point discrimination test and Semmes Weinstein monofilament test were performed for sensory evaluation.

Results

All flaps survived completely at the end of follow-up (mean, 36 months; range 11–64 months). Five patients had cold intolerance and two had hook nails. In total, proximal interphalangeal or distal interphalangeal joint flexion contracture developed in 25 % of the patients. The mean static two-point discrimination score was 4.6 ± 1.6 (2–8) and Semmes–Weinstein monofilament test score was 3.48 ± 0.6 (2.44–4.17). Subjective satisfaction levels of the patients were found to be high and did not show a statistical relationship with the measured clinical outcome parameters (p > 0.05).

Conclusions

Since AHIF contains a solid and continuous neurovascular pedicle, the probability of necrosis and loss of sensation is low in AHIF. In addition, the graft need of the donor area is not high. Its disadvantage is the rate of restriction of joint movements.

Level of evidence

IV.

指神经血管岛状皮瓣在指尖截肢术中的效果。
背景:趾前同指神经血管岛状皮瓣(AHIF)是指尖截肢术中覆盖缺损区、保持手指长度、获得无痛灵敏指尖的方法之一。本研究的目的是评估接受指尖截肢AHIF的患者的功能和感觉结果,并分析患者满意度与结果测量之间的关系。方法:对20例平均年龄37岁(18-63岁)的患者进行回顾性分析。对患者的钩钉发育、指间关节活动、冷耐受性和皮瓣覆盖区的感觉功能进行了评估。采用静态两点判别试验和Semmes-Weinstein单丝试验进行感官评价。结果:所有皮瓣在随访结束时完全存活(平均36个月,范围11-64个月)。5名患者有感冒不耐受,2名患者有钩状指甲。总的来说,25%的患者出现近端指间关节或远端指间关节屈曲挛缩。平均静态两点判别得分为4.6±1.6(2-8),Semmes-Weinstein单丝测试得分为3.48±0.6(2.44-4.17)。患者的主观满意度很高,与测量的临床结果参数没有统计学关系(p>0.05),AHIF中坏死和感觉丧失的概率较低。此外,供体区域的移植物需求并不高。它的缺点是关节运动的限制率。证据级别:四。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信