Handchir Mikrochir Plast Chir 2023; 55(01): 47-52
DOI: 10.1055/a-1862-8129
Original Article

Outcomes of Coverage of Soft Tissue Defects in the Thumb with a “Kite Flap”

Ergebnisse der Defektdeckung am Daumen mittels dem „Kite-Flap“
1   Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland
,
Filip Flicinski
1   Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland
› Author Affiliations

Abstract

Deep soft tissue injuries and defects in the digits such as pulp amputation and degloving injuries are relatively frequent in hand surgical practice. Injuries around the thumb constitute a specific subtype, because their fitting requires the use of techniques that are different from standard. Many different surgical options have been described for the treatment of these serious lesions, depending on site and size of the defect, as well as on bone exposition. The “kite flap” is one of the most popular and frequently used. Results of the treatment of 14 of the 22 patients whose defects in the thumb were fitted with the kite flap are presented. The flaps healed in all patients. At the mean follow-up of 3 years all patients declared satisfaction with the result of surgery. Most of them had slightly limited mobility of the operated thumbs but with no significant translation to the function of the hands, which was very good. The results of this study show that the kite flap is useful in reconstruction of soft tissue defects around the thumb, which are difficult to cover by more conventional techniques

Zusammenfassung

Weichteildefekte an den Fingern wie Fingerkuppenamputationen kommen sehr häufig vor, wobei Defekte am Daumen eine besondere Herausforderung sind. Von den verschiedenen Behandlungsoptionen ist der „Kite-Flap“ eine der am häufigsten verwendeten. Die Ergebnisse der Defektdeckung am Daumen mittels eines „Kite-Flaps“ von 14 von 22 Patienten werden berichtet. Alle Lappen heilten ein. Drei Jahre postoperativ waren alle Patienten mit dem Ergebnis zufrieden. Bei den meisten fand sich eine leichte Bewegungseinschränkung des operierten Daumens, ohne dass dies jedoch die Funktion der Hand beeinträchtigte. Insgesamt hat sich der „Kite-Flap“ zur Defektdeckung am Daumen bewährt.



Publication History

Received: 02 March 2022

Accepted: 23 May 2022

Article published online:
19 July 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Foucher G, Braun JB. A new island flap transfer from the dorsum of the index to the thumb. Plast Reconstr Surg 1979; 63: 344-349
  • 2 Couceiro J, de Prado M, Menendez G. et al. The first dorsal metacarpal artery flap family: a review. Surg J (N Y) 2018; 4: e215-e219
  • 3 Marin-Braun F, Merle M, Foucher G. The kite flap. Ann Chir Main 1988; 7: 147-150
  • 4 Holevich J. A new method of restoring sensibility to the thumb. J Bone Joint Surg Br 1963; 45: 496-502
  • 5 Early MJ, Millner RH. Dorsal metacarpal flaps. Br J Plast Surg 1987; 40: 333-341
  • 6 Molski M, Pisarek W. Functional reconstruction of the palmar surface of the thumb usng the neurovascular flap from the index. Acta Chir Plast 1989; 31: 150-155
  • 7 Molski M, Molski K. Neurovascular skin-bone combined flap from dorsal side of the index finger – a new method of reconstruction of peripheral part of the thumb (English abstract). Chir Narz Ruchu Ortop Pol 2002; 67: 625-631
  • 8 Molski M. Use of the neurovascular flap from dorsal side of the index finger in reconstructions of complex, multi-tissue defects in the thumb (English abstract). Chir Narz Ruchu Ortop Pol 2003; 68: 115-119
  • 9 Williams RL, Nanchahal J, Sykes PJ. et al. The provision of innervated skin cover for the injured thumb using dorsal metacarpal artery island flap. J Hand Surg Br 1995; 20: 231-236
  • 10 Żyluk A, Walszek I, Puchalski P. Use of 1st dorsal metacarpal artery for reconstruction of soft tissue defects in the thumb (English abstract). Chir Narz Ruchu Ortop Pol 2005; 70: 17-20
  • 11 Zhang X, Shao X, Ren C. et al. Reconstruction of thumb pulp defects using a modified kite flap. J Hand Surg Am 2011; 36: 1597-1603
  • 12 Adani R, Mugnai R, Petrella G. Reconstruction of traumatic dorsal loss of the thumb: four different surgical approaches. Hand (N Y) 2019; 14: 223-229
  • 13 Tränkle M, Germann G, Heitmann C. et al. Neurokutaner Insellappen nach Foucher. Weichteildeckung und Rekonstruktion der Sensibilität am Daumen. Chirurg 2004; 75: 996-1002
  • 14 Zhao G, Wang B, Zhang W. et al. Sensory reconstruction in different regions of the digits: A review of 151 cases. Injury 2016; 47: 2269-2275
  • 15 Huart A, Facca S, Lebailly F. et al. Are pedicled flaps feasible in robotic surgery? Report of an anatomical study of the kite flap in conventional surgery versus robotic surgery. Surg Innov 2012; 19: 89-92