A Modified Free Thenar Flap with Constant Innervations and Its Clinical Application

일관된 신경 지배를 위한 유리 무지구피판의 수정과 그의 임상 적용

  • Han, Seung-Kyu (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Yang, Jae-Won (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Kim, Jin-Soo (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Lee, Dong-Chul (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Ki, Sae-Hwi (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Roh, Si-Young (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital)
  • 한승규 (광명성애병원 성형외과) ;
  • 양재원 (광명성애병원 성형외과) ;
  • 김진수 (광명성애병원 성형외과) ;
  • 이동철 (광명성애병원 성형외과) ;
  • 기세휘 (광명성애병원 성형외과) ;
  • 노시영 (광명성애병원 성형외과)
  • Received : 2011.05.01
  • Accepted : 2011.06.21
  • Published : 2011.09.10

Abstract

Purpose: A modified free thenar flap was designed for coverage of volar finger defect with constant innervation using the palmar cutaneous branch of the median nerve. After clinical application of this flap, sensory results were evaluated in 6 cases. Methods: Patients were selected who have volar soft tissue defect with or without fingertip defect. The six cases of the innervated free thenar flap were performed since September 2009, and sensory outcomes were evaluated by the Semmes-Weinstein monofilament and two-point discriminator at four and half month after the surgery. Results: The Semmes-Weinstein Monofilament test revealed 3 cases showed 2.83, 1 case showed 3.61, 1 case showed 4.31 and 1 case showed 4.56. The static two-point discrimination test revealed 1 case showed 4 mm, 1 case showed 6 mm, 2 cases showed 9 mm, and 2 cases showed over 15 mm. The moving two-point discrimination test revealed 1 case showed 3 mm, 1 case showed 4 mm, 1 case showed 5 mm, 1 case showed 7 mm, and 2 cases showed over 15 mm. The donor sites showed no significant limitation of the thumb and neuroma formation. Conclusion: The innervated free thenar flap showed good sensory outcomes as a sensate free flap in a short time after surgery. It can be an option for coverage of volar finger defects that requires sensation.

Keywords

References

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