Comparison of reverse dorsoradial flap for thumb reconstruction: narrow pedicle versus wide pedicle

Abstract

The reverse homodigital dorsoradial flap remains a useful alternative for covering thumb defects. However, the description of pedicle width of dorsoradial flap is not clear. The aim of this study was to compare the results of narrow pedicle with wide pedicle in dorsoradial flaps and describe our experience with the thumb reconstruction. From July 2014 to February 2019, 42 patients were treated with the reverse dorsoradial flap for thumb reconstruction. The patients were divided as Group A (pedicle width ≤ 0.8cm) and Group B (pedicle width > 0.8cm). Flap survival, time to return to work, flap sensibility, the range of motion (ROM) of the joints, and final aesthetic outcomes were evaluated. Respectively in the Group A (17 cases) and Group B (25 cases), 14-19 flaps survived uneventfully, whereas 3-6 flaps experienced venous congestion with no or partial flap loss. No significant difference was identified between the two groups for the incidence of venous congestion, static 2-point discrimination and ROM of the injured thumbs. Time to return to work was significantly shorter in Group A. The aesthetic satisfaction of the patients in Group A was significantly better comparing with that in Group B. The reverse homodigital dorsoradial flap with narrow pedicle width is associated with more favorable outcomes in terms of time lost from work and aesthetic satisfaction of the patients.