Introduction: The purpose of treating thumb finger amputations without any indication for replantation would be to improve functional and esthetic qualities.
Materials and techniques: From March 2005 to October 2008, we treated 14 patients with thumb finger amputation using palmar V-Y flaps coupled with bone and nail grafts. There have been 10 men and 4 women, whose ages at surgery ranged from 19 to 63 years (mean 35.8 years). In most, 11 from the injuries happened within the dominant hands. Based on Allen’s classification, two were type II, seven were type III, and five were type IV. All patients went through emergency surgery, having a time delay after injuries of three-12 h (mean 6.4 h). In every situation, the amputation would be a crush or avulsion injuries, making microsurgical replantation not achievable.
Results: All the flaps survived. At 8-17 several weeks (average 12.8 several weeks) of follow-up, the typical subjective satisfaction score was 8.64. All patients experienced cold intolerance, and no patients reported dysesthesia. Favorable results (excellent or good) put together in 78.6%. Thin primary nails made an appearance around the grafted nail about 3 days after surgery, following that the recently created nail thickened and created a natural appearance. In a single situation, the brand new nail plate demonstrated abnormal thickening because of hyperkeratosis. The bone graft healed at 5 days. The mean two-point discrimination was 7.5 mm. Grip strength was 10% under that within the unaffected hands. Metacarpophalangeal and proximal interphalangeal joint mobility losses were under 10°. All patients came back for their jobs. No patients had postoperative complications.VY-3-135
Conclusions: We feel the mixture of palmar V-Y flap and bone and nail grafts supplies a distinct edge on additional options. It improves function when replantation isn’t an option.