Thenar Flap: A Study of 20 Cases of Industrial Fingertip Injuries, Functional and Aesthetic Outcome
Authors/Creators
- 1. Assistant Professor, Department of General Surgery, Mallareddy Medical College for Women, Suraram, Hyderabad, Telangana
- 2. Associate Professor, Department of Microbiology, Mediciti Institute of Medical Sciences, Medchal, Hyderabad, Telangana
- 3. Post Graduate, Department of Orthopaedics, Mallareddy Medical College for Women, Suraram, Hyderabad, Telangana
- 4. Professor &HOD, Department of Orthopaedics, Mallareddy Medical College for Women, Suraram, Hyderabad, Telangana
Description
Background: Fingertip injuries are the most common injuries, predominant in the industrial production activities. Treatment of fingertip injuries should be based on specific tissue losses. Thenar flaps provide adequate glabrous and durable soft tissue to restore the pulp. Aims & Objectives: Present study demonstrates distinct advantages of thenar flap used for finger pulp reconstruction and evaluates functional and aesthetic aspects of thenar flaps. Materials and Methods: Patients with acute fingertip injuries attending the emergency department of a super speciality hospital which is amidst an industrial zone were included in this prospective study. Thenar flap design was customised according to the defect. Following flap inset, the finger was immobilised in palmar flexion and flap division was performed after 3weeks. Further follow up for assessment of aesthetic (static 2-point discrimination) and functional outcome was done upto six months. The results were analysed by unpaired t-test. Results: A total of 20 fingertip injuries were reconstructed with thenar flap. The sensory assessment at the thenar flap was 2-8mm with mean 5.6+/-1.2. The range of movement was found to be 95-110, 90-100 degrees with mean 98.5+/-2.1, 92.5+/-3.2 at Metacarpophalangeal (MPJ) and Proximal interphalangeal (PIP) joint respectively. During follow up, temporary joint stiffness occurred in two patients, which recovered with strict physiotherapy. No long-term complications, and good patient satisfaction were observed. Conclusion: When proper principles of flap design, care of wound and early mobilization are followed, excellent outcomes can be expected with thenar flaps.
Abstract (English)
Background: Fingertip injuries are the most common injuries, predominant in the industrial production activities. Treatment of fingertip injuries should be based on specific tissue losses. Thenar flaps provide adequate glabrous and durable soft tissue to restore the pulp. Aims & Objectives: Present study demonstrates distinct advantages of thenar flap used for finger pulp reconstruction and evaluates functional and aesthetic aspects of thenar flaps. Materials and Methods: Patients with acute fingertip injuries attending the emergency department of a super speciality hospital which is amidst an industrial zone were included in this prospective study. Thenar flap design was customised according to the defect. Following flap inset, the finger was immobilised in palmar flexion and flap division was performed after 3weeks. Further follow up for assessment of aesthetic (static 2-point discrimination) and functional outcome was done upto six months. The results were analysed by unpaired t-test. Results: A total of 20 fingertip injuries were reconstructed with thenar flap. The sensory assessment at the thenar flap was 2-8mm with mean 5.6+/-1.2. The range of movement was found to be 95-110, 90-100 degrees with mean 98.5+/-2.1, 92.5+/-3.2 at Metacarpophalangeal (MPJ) and Proximal interphalangeal (PIP) joint respectively. During follow up, temporary joint stiffness occurred in two patients, which recovered with strict physiotherapy. No long-term complications, and good patient satisfaction were observed. Conclusion: When proper principles of flap design, care of wound and early mobilization are followed, excellent outcomes can be expected with thenar flaps.
Files
IJTPR,Vol12,Issue8,Article35.pdf
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Additional details
Dates
- Accepted
-
2022-08-30
Software
References
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