THE KITE FLAP IN THE TREATMENT OF FINGER TIP AMPUTATIONS Case Report (original) (raw)
Related papers
The use of flaps in the treatment of fingertip injuries
World Journal of Surgery, 1991
Fingertip injuries constitute a large portion of the traumatic injuries sustained to the hand and are frequently associated with significant disability for the patient. While many methods are available for the treatment of such injuries, quite often only certain procedures are appropriate for a particular digit in any given patient. The use of flaps in such instances provides an important tool for coverage of the exposed fingertip bone when more simple measures are inadequate. Herein follows a discussion of the indications and potential pitfalls for a variety of flaps which may be employed in the treatment of fingertip injuries. Les lésions de la pulpe constituent une proportion importante des lésions traumatiques de la main, et sont souvent responsables d'une incapacité de travail non négligeable. Alors qu'il existe de nombreuse méthodes pour traiter ces lésions, très souvent, un nombre plus restreint de procédés de reconstruction sied parfaitement à tel ou tel doigt chez un patient donné. L'utilisation d'un lambeau dans cette situation constitue un outil capital pour couvrir la pulpe ainsi exposée alors des techniques beaucoup plus simples ne sont pas suffisantes. On présente alors les indications et les écueils potentiels d'une large gamme de lambeaux qui trouvent leurs indications dans le traitement des lésions de la pulpe digitale. Las amputationes distales de los dedos representan una proporción considerable de las lesiones taumáticas de la mano y con frecuencia aparecen asociadas con incapacidad importante para el paciente. Aunque existen muchos métodos disponibles para el tratamiento de tales lesiones, es frecuente que sólo algunos procedimientos resulten apropiados para el manejo de un dedo en particular en un determinado paciente. El uso de colgajos en tales circunstancias constituye un método importante de cobertura del hueso expuesto del dedo, en aquellos casos en que otros métodos más sencillos resulten inadecuados. Se incluye una discusión sobre las indicaciones y potenciales fallas de una variedad de colgajos que pueden ser utilizados en el tratamiento de las lesiones de las puntas de los dedos.
Fingertip Injuries and Amputations: A Review of the Literature
Cureus, 2020
The fingertip is defined as the part of the digit distal to the insertion of the extensor and flexor tendons on the distal phalanx. Devastating injuries to the hand occur every year that lead fingertip amputations in thousands of people. The highest incidence rates are usually seen in children less than five years old and in adults over the age of 65. There are various presentations of injury that may end up with post-traumatic fingertip amputation, including lacerations, avulsions, and crush injuries. The fingertip is vital for sensation, as it has a high concentration of sensory receptors, and hence the restoration of sensation is the most important focus of treatment. The three main goals of treatment are the restoration of sensation and durability in the tip and assuring proper bone support to allow for nail growth. Many complications can arise after fingertip amputation, including delayed wound healing, nail deformities with poor aesthetics, hypersensitivity, residual pain, cold intolerance, scar retraction, flexion contractures, chronic ulceration, infection, and flap loss. The objective of this study is to provide an overview of the anatomy of the fingertip, the presentation of fingertip injuries and their management, and complications that might arise after surgery.
Open treatment of fingertip amputations
Annals of Emergency Medicine, 1983
of Fingertip Amputations Twenty-five patients with fingertip injuries at or distal to the distal interphalangeal joint were treated with a thorough cleansing of the wound with application of bacitracin and a sterile dressing. Warm soaks were begun 48 hours after injury. Crush injury was the most common type of trauma, followed by cutting injuries. Bone involvement was present in six cases. The average healing time was 29 days. At the time of complete healing, sensation was normal in 22 patients (88%). Systemic antibiotics were not administered routinely. No patient developed a wound infection. Our study documents that fingertip amputations can be successfully treated by nonoperative methods that result in preservation of finger length and contour, retention of sensation, and healing without infection.
The Subcutaneous Pulp Flap for Management of Fingertip Injuries - Revisited
Global Journal of Surgery, 2020
Fingertip is the most important part of the finger. It has been described by Moberg as an organ of sensibility or the third eye. Injuries of the fingertips are very frequent as a result of industrial and domestic accidents which can result in permanent disability. We provide our experience about the indications, surgical technique and outcome of subcutaneous pulp flap in management of fingertip.
Finger ? tip injuries are one of the most common injuries faced in the Emergency department of any hospital. This article deals with the experience of our hospital, over a period of 2 Years ? From September 2014 to September 2016 done as a prospective study. Ninety Patients that underwent some form of surgical Procedure were included and followed up over a period of six month. The analysis focused on factors such as mode of injury ? viz. Domestic, Industrial, Road traffic accidents etc, Hand Dominance, Digit involved, Surface involved, Procedure employed, Time taken to return to work, functional outcome and aesthetics. Out of Ninety, Thirty eight patients could be followed up fully. Choice of surgical procedure was made based on the orientation and configuration of the wound. Most of the patients were right handed. Index finger was the commonest digit involved followed by middle, ring, little fingers and thumb. Return to work time was delayed in patients with heterodigital flaps. Most of the patients were satisfied with the aesthetic outcome.
Cross-finger Flap to the Thumb: Quest for an Alternate Donor
Indian Journal of Plastic Surgery, 2020
Background Distal thumb injuries are managed by multiple local and regional flaps. The cross-finger flap (CFF) is one versatile flap used to cover such defects. The donor finger to the thumb is classically described to be the index finger (IF). However, with the index finger being the second most important finger, it causes further debilitation of the already injured hand. Our aim was to find an alternate donor finger to spare the index finger. Methods and Materials A prospective observational study was conducted on 10 patients with distal thumb injuries who were admitted between November 2018 and July 2019. Ring finger (RF) was used as donor for CFF in all the cases. The subjects were assessed for first web space angle, Kapandji score, total range of movement (TRM) of long fingers, and global hand function using Michigan hand outcome questionnaire (MHQ) after flap division. Results There was no first web contracture and TRM of IF remained unaffected. However, TRM of RF was significantly reduced. But this being a relatively unimportant finger, there was no significant reduction in global hand function, as evaluated by the MHQ score. Conclusion The ring finger is a good alternative for index finger as donor for CFF to the thumb, because it provides adequate tissue along with comfortable positioning and easy maintenance of local hygiene. Moreover, it preserves global hand function by sparing the IF.
The Bilobed Racquet Flap or Extended Seagull Flap for Thumb Reconstruction: A Case Report
The journal of hand surgery Asian-Pacific volume, 2018
The treatment of extensive soft tissue defects in the thumb with dorsal metacarpal artery flaps has been previously reported in the literature. Island flaps from the dorsum of the index and long fingers have been the subject of many reports and studies. However, when the defect involves the whole thumb, a 360° circumferential defect, standard first or second dorsal metacarpal artery flaps are usually insufficient. There are fewer reports on the use of bilobed flaps for this application and we have found no reports on the use of bilobed racquet flaps or extended seagull flaps as treatment for this condition. We report the salvage of a thumb degloving injury with use of a bilobed racquet flap.