Long Term Follow Up of Neurovascular Island Flaps for Palmar Skin Defects of Thumb

Journal of the Korean Society for Surgery of the Hand 2001;6(1):35-39.
Published online January 1, 2001.

Dong Churl Kim, Sang Soo Kim, Hong Jun Han, Churl Hong Chun, An Soo So

무지 수장측 피부결손에 대한 신경맥관 도서형 피판술 - 장기 추시 결과 -

김동철, 김상수, 한홍준, 전철홍, 소안수

Abstract

Purpose
: This paper was performed to analyze the clinical results of long-term follow up of 24 neurovascular island flaps(NVIF) for palmar skin defects of thumb. Materials and Methods : From January 1984 to December 1996, we performed NVIFs for reconstruction of the thumb pulp in 63 patients who had showed palmar skin defect of thumb. However there were only 24 patients who could be evaluated the results more than at least 5 years after operation. All cases were treated by the original Littler’s technique. The following parameters were evaluated at the last follow-up examination; recovery of protective sensation, two-point discrimination(2-PD), cold intolerance and range of motion of the thumb, and donor digit morbidity. In our study, we used the author’s criteria that have 4 grades as excellent, good, fair, and poor for convenience to analyze the results of 2-PD. Results : In the last follow-up examination, results by using author’s criteria for 2-PD were excellent; none, good; 10 cases(42%), fair; 8 cases(33%), and poor; 6 cases(25%). But protective sensation was showed in all cases even if in poor grades. There were several kinds of postoperative complications in recipient thumb and donor digit respectively. Complications of recipient thumb were double sensibility in 17 cases(71%), cold intolerance in 10 cases(42%), and flexion deformity of interphalangeal joint less than 10 degree in 4 cases(17%). Complications of donor digit were cold intolerance in 3 cases(13%), extension lag of proximal and distal interphalangeal joint less than 10 degree in 3 cases(13%), and 4 cases(17%) respectively. Conclusion : NVIF is good method to restore the protective sensation on palmar surface of thumb for palmar skin defect of thumb and complications related to this method did not cause any real functional impairment.