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| Purpose Sensate reconstruction with glabrous skin is critical for resurfacing the fingertip or pulp defects. Based on the segmental blood supply from the digital artery to the palmar skin and subcutaneous tissue of the digit with accompanied proper digital innervation, the pivot flap was advocated to reconstruct the fingertip defect.
Methods From Feb. 2007, 21 patients with fingertip or pulp defects were repaired by pivot flaps in our department. The flap size ranged from 1.8×1.5cm to 2.6×2.2cm. The range of motion of the injured digits was measured. Semmes-Weinstein monofilament test, static and moving 2-point discrimination test was also performed to evaluate the sensory of the flap. Michigan Hand Outcomes Questionnaire (MHQ) was used to investigate the Patients' satisfaction with the appearance of the hand, pain, cold intolerance and percussion tenderness of the repaired fingertip was also examined.Results All flaps survived completely. Full motion was maintained at the distal and proximal interphalangeal joints. The mean values of Semmes-Weinstein score was 3.92 g. The mean values of moving and static 2-point discrimination were 3.9 mm and 4.7 mm, respectively. All patients were satisfied with appearance of the fingertips. No painful tips could be found. All flaps have mild cold intolerance and only 1 of the patients complained of mild tenderness with percussion of the fingertip.Conclusions The pivot flap can provide sensate, glabrous skin and is useful for resurfacing fingertip and pulp defects with an aesthetic and functional outcomes. |
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| Keywords:Fingertip, reconstruction, sensory flap, soft tissue. |
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