Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

27 October 2008

Littler's flap revisited: an anatomic study, literature review, and clinical experience in the reconstruction of large thumb-pulp defects

Konstantinos C. XarchasABCDEF, Konstantinos E. TilkeridisABE, Spyridon I. PelekasEF, Konstantinos J. KazakosDF, Despina D. KakagiaDF, Dionysios A. VerettasDF

Med Sci Monit 2008; 14(11): CR568-573 :: ID: 869444

Abstract

Background
An anatomic study and the authors' clinical experience with 15 flaps used for resurfacing sizable thumb defects are presented.
Material and Method
Sixteen upper extremities from fresh cadavers were dissected to delineate the anatomy, vascular pattern, and reconstructive potential of the heterodigital island flap. Fifteen heterodigital island flaps were also performed between 1996 and 2004 in 15 patients (mean age: 41.2 years) suffering from a major trauma of the thumb. Flap and donor site skin quality, scar contractures, finger mobility expressed in terms of total active movement, sensibility evaluated by two-point discrimination and the Semmes-Weinstein (SW) monofilament tests, cold intolerance, double-sensibility phenomenon, and cosmetic results were assessed. All patients were reviewed over a postoperative follow-up period of 10-18 months.
Results
Good coverage with well-vascularized skin was obtained and donor-finger full-thickness skin grafting was successful in all cases. All flaps survived completely. Mild cold intolerance was seen in all donor fingers, but no flap had hyperesthesia 10 months postoperatively. Total active range of motion was rated as good or excellent in all patients for both the donor finger and the thumb. Sensation in the donor finger was reported as "slightly altered" and the double-sensibility phenomenon was present in all patients.
Conclusions
The heterodigital arterialized flap is a single-stage, thin, fairly mobile flap that produces an excellent cosmetic result, restores sensibility, and enables early mobilization of the hand. Morbidity in the donor finger is within acceptable limits and its usefulness in the reconstruction of thumb pulp defects is well documented.

Keywords: Thumb - surgery, young adult, Surgical Flaps, Reconstructive Surgical Procedures - methods, Cadaver

Add Comment 0 Comments

Editorial

01 March 2024 : Editorial  

Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-Thalassemia

Dinah V. Parums

DOI: 10.12659/MSM.944204

Med Sci Monit 2024; 30:e944204

0:00

In Press

18 Mar 2024 : Clinical Research  

Sexual Dysfunction in Women After Tibial Fracture: A Retrospective Comparative Study

Med Sci Monit In Press; DOI: 10.12659/MSM.944136  

0:00

21 Feb 2024 : Clinical Research  

Potential Value of HSP90α in Prognosis of Triple-Negative Breast Cancer

Med Sci Monit In Press; DOI: 10.12659/MSM.943049  

22 Feb 2024 : Review article  

Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...

Med Sci Monit In Press; DOI: 10.12659/MSM.943168  

23 Feb 2024 : Clinical Research  

A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...

Med Sci Monit In Press; DOI: 10.12659/MSM.943732  

Most Viewed Current Articles

16 May 2023 : Clinical Research  

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387

0:00

17 Jan 2024 : Review article  

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799

0:00

14 Dec 2022 : Clinical Research  

Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels

DOI :10.12659/MSM.937990

Med Sci Monit 2022; 28:e937990

0:00

01 Jan 2022 : Editorial  

Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...

DOI :10.12659/MSM.935952

Med Sci Monit 2022; 28:e935952

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750