ISSN: 1859 - 2872
Results of thumb reconstruction using kite flap at 108 Military Central Hospital
Main Article Content
Keywords
Abstract
Objective: To evaluate the results of treating soft tissue defects of the thumb using kite flaps at 108 Military Central Hospital. Subject and method: From April 2022 to April 2024, 17 patients with soft tissue defects of the thumb underwent flap reconstruction at the Department of Upper Limb Surgery and Microsurgery. There were 14 male and 3 female patients, with an average follow-up time of 15.2 months (ranging from 7 to 24 months). Sensory function was assessed using two-point discrimination and cortical reorientation. The thumb's mobility was evaluated using the Kapandji score. Aesthetic results were objectively assessed by the surgeon, and patients' subjective satisfaction was measured using a visual analog scale. Result: The average flap size was 32.1 × 17mm. All donor sites were covered with full-thickness skin grafts. Sixteen flaps survived completely, while one flap experienced distal necrosis and was treated conservatively. The average two-point discrimination was 11.2mm, with cortical reorientation completed in 58.8%. The average Kapandji score was 7.5. Aesthetic results were rated as excellent in 9 patients, good in 7 patients, and poor in 1 patient. After the follow-up period, the average subjective satisfaction score was 8.1. Most patients regained all functions of the thumb and index finger and were satisfied with the aesthetic appearance of the flap and the donor site. Conclusion: The kite flap, or first dorsal metacarpal artery flap (FDMA flap), provides flexible and versatile coverage for soft tissue defects of the thumb ranging from small to medium size. Furthermore, it yields good functional and aesthetic outcomes with minimal donor site morbidity.
Article Details
References
2. Kapandji A (1986) Clinical test of apposition and counter-apposition of the thumb. Ann Chir Main. 5: 67-73. doi: 10.1016/s0753-9053(86)80053-9.
3. Foucher G, Braun JB (1979) A new island flap transfer from the dorsum of the index to teh thumb. Plast Reconstr Surg 63: 344349. doi: 10.1097/00006534-197903000-00008.
4. Satish C, Nema S (2009) Vạt đảo động mạch bàn tay mu bàn tay đầu tiên: Một vạt hữu ích để tái tạo khuyết tật tủy ngón tay cái. Indian J Plast Surg 42: 32 - 5.
5. El Khatib HA (1998) Kinh nghiệm lâm sàng với vạt đảo động mạch mu bàn tay thứ nhất mở rộng để tái tạo ngón tay cái. J Hand Surg [Am] 23: 647-652. doi: 10.1016/S0363-5023(98)80050-6.
6. Tränkle M, Sauerbier M, Heitmann C, Germann G (2003) Restoration of thumb sensibility with the innervated first dorsal metacarpal artery island flap. J Hand Surg 28: 758-766.
7. Muyldermans T, Hierner R (2009) First dorsal metacarpal artery flap for thumb reconstruction: a retrospective clinical study. Strategies Trauma Limb Reconstr 4: 27-33.
8. Kola N (2016) Thumb Reconstruction Using Foucher’s Flap. J Med Sci 4: 70-73. doi: 10.3889/oamjms.2016.017.
9. Eski M, Nisanci M, Sengezer M (2007) Correction of thumb deformities after burn: Versatility of first dorsal metacarpal artery flap. Burns 33: 65-71. doi: 10.1016/j.burns.2006.04.030.
10. Ege A, Tuncay I, Ercetin O (2002) Foucher’s first dorsal metacarpal artery flap for thumb reconstruction: Evaluation of 21 cases. Isr Med Assoc J 4: 421-423.
11. Ratcliffe RJ, Regan PJ, Scerri GV (1992) First dorsal metacarpal artery flap cover for extensive pulp defects in the normal length thumb. Br J Plast Surg 45: 544-546. doi: 10.1016/0007-1226(92)90152-n.
12. Sherif MM (1994) First dorsal metacarpal artery flap in hand reconstruction II Clinical application. J Hand Surg 19: 32-38. doi: 10.1016/0363-5023(94)90221-60.
Article Sidebar
