Direct and Reversed Dorsal Digital Island Flaps: A Review of 65 Cases

N/ACompletedNCT02102035

The Second Hospital of Tangshan65 enrolled

Overview

Reconstruction of soft tissue defects in the fingers continues to be a challenge problem. The study reports reconstruction of small to moderate defects of the fingers with the direct and reversed dorsal digital island flaps and evaluates the results of the use of the flaps.The main outcomes are static 2-point discrimination and Semmes-Weinstein monofilament scores of the flap and joint motion.

At final follow-up, sensory restoration of the flap is measured using the static 2-point discrimination (2PD) test and Semmes-Weinstein monofilament (SWM) test. Active motion of the joints is measured using a standard hand goniometer. For the direct DDIF, total active motion is calculated as the sum of degrees of active flexion of the interphalangeal and the metacarpophalangeal joints subtracted from the degrees of extension deficit. For the reversed DDIF, total active motion of the donor finger is calculated as the sum of degrees of active flexion of the proximal and distal interphalangeal joints subtracted from the degrees of extension deficit.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Soft Tissue Reconstruction Sensory Restoration

Interventions

Direct and reversed dorsal digital island flapPROCEDURE

The direct dorsal digital island flap is used to cover the defects of adjacent fingers. The reversed dorsal digital island flap is used to cover the defects of the same fingers.

Eligibility

Sex: ALLMin age: 15 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * a defect greater than or equal to 1.5 cm in length * the defects on the dorsal and lateral aspects of the fingers * the defects located between the distal 1/2 of the middle phalanx and the tip of the finger * a patient between 15 and 60 years of age. Exclusion Criteria: * injuries involving the donor sites or the course of the vascular pedicle * a defect less than 1.5 cm in length.

Locations (1)

The Second Hospital of Tangshan

Tangshan, Hebei, China

Outcomes

Primary Outcomes

Static 2-point discrimination test

The test points are at the center of the flap. Each area is tested 3 times with a Discriminator (Ali Med, Dedham, MA). We stop at 4mm as a limit of static 2-point discrimination test and consider this normal.

Time frame: 16 to 24 months

Secondary Outcomes

Total active motion

Active motion of the joints is measured using a standard hand goniometer. For the direct DDIF, total active motion is calculated as the sum of degrees of active flexion of the interphalangeal and the metacarpophalangeal joints subtracted from the degrees of extension deficit. For the reversed DDIF, TAM of the donor finger is calculated as the sum of degrees of active flexion of the proximal and distal interphalangeal joints subtracted from the degrees of extension deficit.

Time frame: 16-24 months

Data from ClinicalTrials.gov

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