THE VALUATION OF LOCAL FLAP IN RECONSTRUCTION OF FINGERTIP INJURY

Journal of the Korean Society for Surgery of the Hand 1997;2(1):40-46.
Published online January 1, 1997.

Dong Gil Han,Ki Young Ahn,Dae Hwan Park

수지 첨부 손상 재건을 위한 각 국소 피판 술식간의 유용성

한동길,안기영,박대환

Abstract

Local flap reconstruction among various procedures for reconstruction of fingertip injury are challenge for surgeon due to relatively shortage of available skin around digit. So, it is necessary to choose adequate procedure for the best result based on consideration of general principles, knowledge of accurate anatomy, easiness of technical skill, and comparison of advantages, disadvantages and results between various procedures. To assess the value of each local flap procedures, 88 local flap procedures from May, 1990 to May, 1995 were studied retrospectively and followed up for more than 6 months, and then, local flap procedures were divided into 5 groups as group of homodigit innervated advance- ment procedures(volor advancement, volar V-Y, lateral V-Y), group of homodigit innervated island procedures(innervated reverse digital artery, step advancement), group of heterodigit innervated island procedures(neurovascular island, radial innervated dorsal island), group of homodigit non-innervated procedure(reverse digital artery, reverse dorsal digital island), group of heterodigit non-innervated procedures(cross finger, flag, thenar), and analysis of results were made based on advantages, disadvantages and two-point discrimination(2PD). The best result of average 2PD was group of homodigitinnervated advancement procedures, and average 2PD of group of heterdigit innervated island procedures was relatively poor than the other three groups. In summary, comparing together 2PD with advantages and disadvantages, it is better to choose homodigit innervated advancement procedure as first choice for reconstruction of tmgertip injury if possible, and if not, relatively good result can obtain from the other three groups except group of heterodigit innervated island procedure, and it is like to choose heterodigit innervated island procedures as secondary choice.