Evaluation of moving and static two point discriminations of volar forearm skin before and after transfer as a sensate radial forearm island flap in reconstruction of degloving injury of the thumb

J Plast Reconstr Aesthet Surg. 2007;60(4):356-9. doi: 10.1016/j.bjps.2006.05.001. Epub 2006 Jul 25.

Abstract

In degloving injury of the thumb the large skin defect needs cover with sensate, glabrous and pliable skin. Although coverage of this defect with a sensate free flap from the foot is the best choice, most commonly, cover is achieved using a non-sensate distant pedicle flap. Between 2001 and 2003, degloving injuries of the thumb in eight patients were reconstructed using a sensate radial forearm flap in the sensory territory of the lateral ante-brachial nerve of the forearm which was repaired to the digital nerve of the thumb (six cases) or to a branch of the sensory radial nerve (two cases). Follow-up period ranged from 17 to 41 months (mean: 29.9 months). Sensory evaluation was performed using the moving two point discrimination (M-2PD) and static two point discrimination (S-2PD) of the volar forearm skin. These altered significantly after transfer and their values approached those of the contra-lateral thumb but never reached normal sensation (p<0.01). Sensate radial forearm island flap is a reliable option to cover a large defect of the thumb such as degloving injury and the sensation produced is acceptable.

MeSH terms

  • Adult
  • Follow-Up Studies
  • Forearm
  • Hand Injuries / surgery*
  • Humans
  • Iran
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Surgical Flaps*
  • Thumb / injuries*
  • Thumb / surgery
  • Treatment Outcome