Factors affecting sensory recovery after thumb reconstruction using a wrap-around flap.

Abstract

This study evaluated factors affecting sensory restoration after thumb reconstruction using a wrap-around flap in 21 thumbs in patients aged 11 to 50years old. The patients were followed from 12 to 94months after surgery. Static and moving 2-point discrimination of the reconstructed pulp was measured and analysed using multiple regression analysis. According to the univariate and multivariate analyses, the preoperative period, the number of nerve coaptations, and the duration of follow-up all significantly affected sensory recovery. Sensory recovery with more than three coaptations was significantly better than those with less than three coaptations, and the number of nerve coaptations was one of the primary factors influencing sensory recovery. We conclude from this study that the wrap-around flap should be performed soon after injury and that surgeons should try to coaptate three or more nerves to enhance sensory recovery.Level of evidence: IV.