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Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap

BACKGROUND: Reconstruction of complex soft tissue defects of the thumb, with exposure of tendons, joints or bones, has always been a difficult task. We evaluated the functional and esthetic outcomes of 1(st) dorsal metacarpal artery island flap in reconstruction of post-traumatic soft tissue defects...

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Autores principales: Ghoraba, Samir M, Mahmoud, Wael H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Iranian Society for Plastic Surgeons 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066707/
https://www.ncbi.nlm.nih.gov/pubmed/30083496
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author Ghoraba, Samir M
Mahmoud, Wael H
author_facet Ghoraba, Samir M
Mahmoud, Wael H
author_sort Ghoraba, Samir M
collection PubMed
description BACKGROUND: Reconstruction of complex soft tissue defects of the thumb, with exposure of tendons, joints or bones, has always been a difficult task. We evaluated the functional and esthetic outcomes of 1(st) dorsal metacarpal artery island flap in reconstruction of post-traumatic soft tissue defects of the thumb. METHODS: Between January 2012 and June 2014, fifteen patients with complex post-traumatic soft tissue thumb defects underwent 1(st) dorsal metacarpal artery island flap. Sensory function was evaluated with static 2-point discrimination and cortical reorientation. The mobility of the thumb was tested by the Kapandji score. The esthetic outcome was assessed. Patient’s subjective satisfaction was evaluated by the visual analogue scale. RESULTS: The mean flap size was 33.3×17.7 mm. All donor sites were grafted by full-thickness skin grafts from the groin. Fourteen flaps survived completely and one had distal flap necrosis was treated conservatively. The mean static two-point discrimination was 10.4 mm. Cortical reorientation was complete in 40%. The average Kapandji score was 7.1. The esthetic outcome was excellent in six, good in eight and poor in one subject. After a mean follow up period of 18.2 months, the mean subjective satisfaction score was 8.1; most patients regained all functions of the thumb and index finger and were pleased with the cosmetic appearance of the flap and donor site. CONCLUSION: First dorsal metacarpal artery flap offers a sensate, pliable and versatile coverage for small to moderate sized thumb defects. Moreover, it provides good functional and esthetic outcomes with minimal donor site morbidity.
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spelling pubmed-60667072018-08-06 Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap Ghoraba, Samir M Mahmoud, Wael H World J Plast Surg Original Article BACKGROUND: Reconstruction of complex soft tissue defects of the thumb, with exposure of tendons, joints or bones, has always been a difficult task. We evaluated the functional and esthetic outcomes of 1(st) dorsal metacarpal artery island flap in reconstruction of post-traumatic soft tissue defects of the thumb. METHODS: Between January 2012 and June 2014, fifteen patients with complex post-traumatic soft tissue thumb defects underwent 1(st) dorsal metacarpal artery island flap. Sensory function was evaluated with static 2-point discrimination and cortical reorientation. The mobility of the thumb was tested by the Kapandji score. The esthetic outcome was assessed. Patient’s subjective satisfaction was evaluated by the visual analogue scale. RESULTS: The mean flap size was 33.3×17.7 mm. All donor sites were grafted by full-thickness skin grafts from the groin. Fourteen flaps survived completely and one had distal flap necrosis was treated conservatively. The mean static two-point discrimination was 10.4 mm. Cortical reorientation was complete in 40%. The average Kapandji score was 7.1. The esthetic outcome was excellent in six, good in eight and poor in one subject. After a mean follow up period of 18.2 months, the mean subjective satisfaction score was 8.1; most patients regained all functions of the thumb and index finger and were pleased with the cosmetic appearance of the flap and donor site. CONCLUSION: First dorsal metacarpal artery flap offers a sensate, pliable and versatile coverage for small to moderate sized thumb defects. Moreover, it provides good functional and esthetic outcomes with minimal donor site morbidity. Iranian Society for Plastic Surgeons 2018-05 /pmc/articles/PMC6066707/ /pubmed/30083496 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ghoraba, Samir M
Mahmoud, Wael H
Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap
title Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap
title_full Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap
title_fullStr Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap
title_full_unstemmed Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap
title_short Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap
title_sort outcome of thumb reconstruction using the first dorsal metacarpal artery island flap
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066707/
https://www.ncbi.nlm.nih.gov/pubmed/30083496
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