PDF herunterladen
CC BY-NC-ND 4.0 · Indian J Plast Surg 2020; 53(02): 287-292
DOI: 10.1055/s-0040-1714181
Original Article

Cross-finger Flap to the Thumb: Quest for an Alternate Donor

Madhavi Chitta
1   Department of Plastic Surgery, Government Medical College, Gandhinagar, Kottayam, Kerala, India
,
Lekshmi Malathi 
1   Department of Plastic Surgery, Government Medical College, Gandhinagar, Kottayam, Kerala, India
,
Aneesh Joseph
1   Department of Plastic Surgery, Government Medical College, Gandhinagar, Kottayam, Kerala, India
› Institutsangaben Funding No financial disclosure to be made by any of the authors.
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Background Distal thumb injuries are managed by multiple local and regional flaps. The cross-finger flap (CFF) is one versatile flap used to cover such defects. The donor finger to the thumb is classically described to be the index finger (IF). However, with the index finger being the second most important finger, it causes further debilitation of the already injured hand. Our aim was to find an alternate donor finger to spare the index finger.

Methods and Materials A prospective observational study was conducted on 10 patients with distal thumb injuries who were admitted between November 2018 and July 2019. Ring finger (RF) was used as donor for CFF in all the cases. The subjects were assessed for first web space angle, Kapandji score, total range of movement (TRM) of long fingers, and global hand function using Michigan hand outcome questionnaire (MHQ) after flap division.

Results There was no first web contracture and TRM of IF remained unaffected. However, TRM of RF was significantly reduced. But this being a relatively unimportant finger, there was no significant reduction in global hand function, as evaluated by the MHQ score.

Conclusion The ring finger is a good alternative for index finger as donor for CFF to the thumb, because it provides adequate tissue along with comfortable positioning and easy maintenance of local hygiene. Moreover, it preserves global hand function by sparing the IF.

Keywords

Cross-finger flap - donor finger - ring finger - thumb injury - thumb reconstruction


Publikationsverlauf

Artikel online veröffentlicht:
13. Juli 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Lee KK. Thumb Reconstruction WPA. In: Green’s Operative Hand Surgery 6th Edition. 6th ed. 1839-1852
    Google Scholar
  • 2 Karthikeyan GR. Versatility and modifications of CFF in hand surgery.pdf. Int J Sci Stud 2017; 5 (06) 35-46
    Google Scholar
  • 3 David A, Kappel JGB. The cross finger flap HC 1985 Kappel.pdf. Hand Clin 1985; 1 (04) 677-683
    CrossrefPubMedGoogle Scholar
  • 4 Vedder NB, Friedrich JB. Thumb reconstruction: Non-microsurgical techniques. In: Peter (Editor in Chief) CN, James (Volume Editor) C. eds. Plastic Surgery Volume 6. 4th ed. 2018: 305-306
    Google Scholar
  • 5 Smith P. Reconstruction. In: Smith P. ed. Lister’s The Hand: Diagnosis and Indications. 4th ed. Churchil Livingston; 2002: 145-146
    Google Scholar
  • 6 Koch H, Kielnhofer A, Hubmer M, Scharnagl E. Donor site morbidity in cross-finger flaps. Br J Plast Surg 2005; 58 (08) 1131-1135
    CrossrefPubMedGoogle Scholar
  • 7 Paterson P, Titley OG, Nancarrow JD. Donor finger morbidity in cross-finger flaps. Injury 2000; 31 (04) 215-218
    CrossrefPubMedGoogle Scholar
  • 8 Atasoy E. The reverse cross finger flap. J Hand Surg Am 2016; 41 (01) 122-128
    CrossrefPubMedGoogle Scholar
  • 9 Ghoraba SM, Mahmoud WH. Outcome of thumb reconstruction using the first dorsal metacarpal artery island flap. World J Plast Surg 2018; 7 (02) 151-158
    PubMedGoogle Scholar
  • 10 Kenney RJ, Hammert WC. Physical examination of the hand. J Hand Surg Am 2014; 39 (11) 2324-2334, quiz 2334
    CrossrefPubMedGoogle Scholar
  • 11 Shauver MJ, Chung KC. The Michigan hand outcomes questionnaire (MHQ) after 15 years of field trial. Plast Reconstr Surg 2013; 131 (05) 779e-787e
    CrossrefPubMedGoogle Scholar
  • 12 Chung KC, Pillsbury MS, et al. Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand Surgery 1998;23A; 575–587
  • 13 Woon CYL, Lee JYL, Teoh LC. Resurfacing hemipulp losses of the thumb: the cross finger flap revisited: indications, technical refinements, outcomes, and long-term neurosensory recovery. Ann Plast Surg 2008; 61 (04) 385-391
    CrossrefPubMedGoogle Scholar
  • 14 Mutaf M, Sensöz O, Ustüner ET. A new design of the cross-finger flap: the C-ring flap. Br J Plast Surg 1993; 46 (02) 97-104
    CrossrefPubMedGoogle Scholar