Kumta S M, Yip K M, Pannozzo A, Fong S L, Leung P C
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong.
J Reconstr Microsurg. 1997 Feb;13(2):117-22; discussion 122-3. doi: 10.1055/s-2007-1000227.
The problems of late deterioration of sensation and a "double sensibility" phenomenon, either in the thumb or donor finger, are a known deficiency of the conventional heterodigital neurovascular island flap. This is probably related to unsatisfactory cortical reorientation following flap transfer. To obviate this problem, the authors have used a disconnection/reconnection technique for heterodigital island flaps in 17 patients, to resurface defects in the skin of the thumb. All patients were followed-up for 1 year, while 15 were followed-up for 2 years or more. There were no flap complications or failures, and the length of the thumb tip was preserved in all cases. The classic two-point discrimination was less than 6 mm in eight of these patients, and the remaining nine patients had two-point discrimination of between 6 and 8 mm. This technique was found to provide sensitive, supple, and well-vascularized skin with proper cortical representation, to replace the loss of the tactile pump of the thumb tip in one operative stage.
