Bilaterally Innervated Sensory Dorsal Digital Flaps for Sensory Reconstruction of the Fingers

Sensory coverage in the finger continues to be a challenging problem. This study reports sensory reconstruction of the fingers with the bilaterally innervated dorsal digital flaps and compares the results between the dual- and single-innervated flaps.The main evaluated outcomes are static 2-point discrimination and Semmes-Weinstein monofilament scores of the flap, fingertip pain and joint motion.

Pain was given subjectively by the patient using the visual analogue scale (VAS). The VAS consists of a 10 cm line that was grouped into mild (0-3 cm), moderate (4-6 cm) and severe (7-10 cm). Tinel's sign was rated as the following: grade 1=none; grade 2=mild, slight tingle; grade 3=moderate, very uncomfortable; and grade 4=severe, patient unable to use hand because of any stimulation of the neuroma.

Inclusion Criteria:

• a soft-tissue defect in the areas where sensory return was considered important ●a defect with exposed bone or tendon in one finger
• the defect associated with the transected digital nerves in both sides
• a defect greater than 1.5 cm
• a patient aged 15 to 60 years

Exclusion Criteria:

• injuries to the dorsum of the finger or to the course of the vascular pedicle that precluded its use as the donor
• injuries to the dorsal branches of the digital nerves that precluded its use as donor nerves attached with the flap
• a defect less than or equal to 1.5 cm
• patient age < 15 years or > 60 years