Clinical outcomes of reposition flap transfer for fingertip amputation.

Autor: Nakanishi A; Department of Orthopaedic Surgery, Ichinomiya-Nishi Hospital, Ichinomiya, Japan., Kawamura K; Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-Cho, Kashihara, Nara, 634-8522, Japan. kkenji@naramed-u.ac.jp., Omokawa S; Department of Hand Surgery, Nara Medical University, 840 Shijyo-Cho, Kashihara, Nara, 634-8522, Japan., Hasegawa H; Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-Cho, Kashihara, Nara, 634-8522, Japan., Tanaka Y; Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-Cho, Kashihara, Nara, 634-8522, Japan.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2024 Apr; Vol. 34 (3), pp. 1627-1634. Date of Electronic Publication: 2024 Feb 17.
DOI: 10.1007/s00590-024-03854-5
Abstrakt: Purpose: This study aimed to describe the reposition flap for reconstructing fingertip amputation when replantation is not possible.
Methods: This study retrospectively reviewed the records of patients with reposition flap transfers and investigated postoperative clinical outcomes and patient satisfaction. Sixteen patients with fingertip amputations treated with a reposition flap from 2016 to 2020. The mean age at injury was 46 years (range, 26-70 years). Ten cases were treated with oblique triangular advancement flaps, 3 with retrograde-flow digital artery flaps, and 3 with thumb palmar advancement flaps. Postoperative outcomes, including wound healing period and the IP/PIP extension angle, and the presence of grafted bone absorption and patient satisfaction were evaluated as of 3 years after surgery.
Results: The average reduction in passive extension angle of the IP/PIP joint was 19°. The average time for complete wound healing was 28 days (range, 18-41 days). The reduction in passive extension angle of the IP/PIP joint was significantly correlated with the wound healing period (r = 0.66, p = 0.01). The absorption of the grafted bone was observed in 3 cases. In these cases, the distal tip of the flap became thin due to flap retraction and an insufficient flap volume. All patients were highly or fairly satisfied with the results of surgery.
Conclusion: Our findings show that IP/PIP flexion contracture can occur due to delayed wound healing after reposition flap transfer, but the patient satisfaction level was generally high. Therefore, reconstruction using a reposition flap gives acceptable clinical outcomes and high patient satisfaction as a result of medium to long-term.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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