Elsherbeny, K., Hweidi, A., Gad, A. (2023). Nerve Sparing Antegrade Homodigital Island Flap. The Egyptian Journal of Plastic and Reconstructive Surgery, 47(2), 157-164. doi: 10.21608/ejprs.2023.291385
Khaled M Elsherbeny; Ahmed S Hweidi; Ahmed M Gad. "Nerve Sparing Antegrade Homodigital Island Flap". The Egyptian Journal of Plastic and Reconstructive Surgery, 47, 2, 2023, 157-164. doi: 10.21608/ejprs.2023.291385
Elsherbeny, K., Hweidi, A., Gad, A. (2023). 'Nerve Sparing Antegrade Homodigital Island Flap', The Egyptian Journal of Plastic and Reconstructive Surgery, 47(2), pp. 157-164. doi: 10.21608/ejprs.2023.291385
Elsherbeny, K., Hweidi, A., Gad, A. Nerve Sparing Antegrade Homodigital Island Flap. The Egyptian Journal of Plastic and Reconstructive Surgery, 2023; 47(2): 157-164. doi: 10.21608/ejprs.2023.291385
The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: Fingertip reconstruction requires stable, sensate, and painless padding. Digital defects proximal to the tip around distal interphalangeal joint or dorsal raw areas preclude these objectives except for preserving the sensation to the fingertip. Antegrade Homodigital island flap accomplishes these objectives for fingertip defect coverage. Objective: In this case series, we modify this flap to cover different defects proximal to the fingertip while sparing the digital nerve to preserve fingertip sensation. Material and Methods: Between March 2019 till June 2022 Fourteen patients (fifteen finger) with deformed distal phalanges, contracted distal interphalangeal joint, or defects sparing the finger tips were treated with a nerve sparing antegrade homodigital island flap. The mean age was 27±17 years old. The etiologies were post-traumatic, post-burn or firearm injury. Follow-up period ranged from 4-18 months. Results: All flaps survived with delayed wound healing in two flaps and proximal interphalangeal joint 15 degrees' extension lag in one patient. Fingertip sensation was preserved in all patients with mean 2 point-discrimination (2PD) test 3±1mm. We evaluated patient satisfaction regarding cosmetic and functional outcomes. Conclusion: Nerve sparing antegrade homodigital island flap is considered a reasonable choice for covering finger defects proximal to the fingertips. It provides durable, robust, and aesthetically accepted coverage.
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