Are cross finger and thenar flaps effective in the treatment of distal finger amputations with the reposition-flap method?

Abstract

The aim of this study was to evaluate the effectiveness of using cross finger and thenar flaps in treatment of distal fingers amputations with reposition-flap method. Between September 2017 and January 2020, a total of 20 fingers of 19 patients (15 males, 4 females; mean age: 31.6±10.4 years; range, 19 to 52 years) who were treated with repositioning using a cross finger or thenar flap were retrospectively analyzed. Finger length, flap status, pain, cold intolerance, two-point discrimination, bone healing and appearance of the nail were recorded. Functional evaluation was performed using the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) score and range of motion. The mean follow-up was 19.5±5.2 months. A poor result was seen in one patient with the development of necrosis in the flap. With the exception of one finger with necrosis in the flap, no major complications were observed. Union was achieved in all other bones. The mean shortness was 3.7±1.9 mm. The mean Quick-DASH score was 4.5±5.0 and the mean two-point discrimination test was measured as 6.8±0.9. In fingertip amputations repositioning with a cross finger or thenar flap can achieve a near-normal fingertip appearance with the advantages for the surgeon of a short learning curve and no requirement for microsurgery experience. If replantation cannot be applied in fingertip amputations, this method should be considered among the treatment options, particularly for patients with high aesthetic expectations.