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J Reconstr Microsurg 2014; 30(01): 015-020
DOI: 10.1055/s-0033-1345430
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Restoration of Thumb Sensibility with Innervated Reverse Homodigital Dorsoradial Flap

Qi Yuan Bao
1   Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
2   Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
3   Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
,
Cheng Wei Xiao
1   Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
2   Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
3   Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
,
Feng Peng
1   Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
2   Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
3   Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
,
Dong Han
1   Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
2   Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
3   Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
,
Tao Wang
1   Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
2   Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
3   Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
,
Yu Dong Gu
1   Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
2   Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
3   Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
› Author Affiliations
Further Information

Publication History

06 September 2012

03 February 2013

Publication Date:
20 June 2013 (online)

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Abstract

Purpose This study investigates the use of homodigital reverse dorsoradial flap with neurorrhaphy for thumb soft tissue defect.

Methods From 1996 to 2010, the homodigital dorsoradial flap was performed on seven adult patients and one 3-year-old boy. The flaps ranged from 1.2 to approximately 3.0 cm × 2.0 to approximately 4.2 cm in size. In six of the eight patients, the dorsal collateral branch of the radial nerve supplying the flap was also included in the pedicle and coapted to the proper digital nerves of the thumb. At final follow-ups, flap sensation, thumb motion, and donor-site morbidity were assessed.

Results All flaps survived completely. At final follow-up of 8.5 months (range, 3 to 14 months), all patients except the 3-year-old child (who could not express clearly) reported satisfactory sensory recovery, with the static two-point discrimination ranging between 6 and 12 mm (mean, 9.4 mm). Range of motion of the metacarpophalangeal and interphalangeal joints of the thumbs was also preserved with minimal donor-site morbidity in all cases.

Conclusions Innervated reverse homodigital dorsoradial flap serves as a reliable and sensate flap for extensive thumb soft tissue reconstruction.

Keywords

homodigital flap - soft tissue defect - neurorrhaphy