Relationship between sensory recovery and advancement distance of oblique triangular flap for fingertip reconstruction.

PURPOSE: Oblique triangular flaps often need extensive advancement for fingertip coverage. The purpose of this report is to retrospectively investigate the relationship between sensory recovery and advancement distance of oblique triangular flaps.

METHODS: Fourteen consecutive fingertip amputations in 11 patients were treated with oblique triangular flaps between 2005 and 2006. These cases had been regularly followed up (range, 14-21 months) until sensory recovery of the fingertip covered with the flap reached a plateau, and then final sensory condition was evaluated with the Semmes-Weinstein monofilament test and a moving 2-point discrimination test, in addition to evaluation of existence of dysesthesia.

RESULTS: Dysesthesia existed in 7 fingers, and there was an associated a significant difference between a flap advancement distance of more than 12 mm and a flap advancement distance of less than 12 mm. In an objective evaluation of whether the 2.83 monofilament (0.086 g) could be recognized in the Semmes-Weinstein test, there was also an associated significant difference between a flap advancement distance of more than 12 mm and a flap advancement distance of less than 12 mm.

CONCLUSIONS: Good sensory recovery occurred in cases with less than 12 mm flap advancement. In cases where the flap was advanced more than 12 mm, sensory disturbance of the fingertip occurred and did not subside.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.