Direct and Reversed Dorsal Digito-metacarpal Flaps: A Review of 24 Cases

NCT ID: NCT01927003

Last Updated: 2018-10-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 24 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2009-04-30
• Study Completion Date: 2012-09-30

Brief Summary

Multiple digital injuries are often complex and severe, and the commonly used local and regional flaps may not be feasible. The authors reconstruct soft tissue defects of the fingers using the dorsal digito-metacarpal flap and evaluate the efficacy of this technique.

Detailed Description

At final follow-up, we measure the sensibility of the flaps using the static 2-point discrimination test. The Static 2-point discrimination test determines the minimal distance at which a subject can sense the presence of two needle. The modified American Society for Surgery of the Hand guidalines are used to stratify discriminator measurements(excellent <6 mm, good 6-10 mm, fair 11-15 mm, poor >15 mm). Each area is tested 3 times with a Discriminator (Ali Med, Dedham, MA). Two out of 3 correct answers are considered proof of perception before proceeding to another lower value. We stopp at 4mm as a limit of 2PD and consider this normal. The measurements are performed at a single time point at final follow up.

Conditions

Finger Injuries; Soft Tissue Injuries

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Surgical flap

Dorsal digito-metacarpal flap is based on the dorsal digital artery and dorsal metacarpal artery.

Group Type: EXPERIMENTAL

Dorsal digito-metacarpal flap

Intervention Type: PROCEDURE

The dorsal digito-metacarpal flap is a vascular island flap based on the dorsal digital artery and dorsal metacarpal artery. It has a longer vascular pedicle and provides tissue coverage of similar quality as that of normal glabrous skin but not sacrifice the digital artery.

Interventions

Dorsal digito-metacarpal flap

The dorsal digito-metacarpal flap is a vascular island flap based on the dorsal digital artery and dorsal metacarpal artery. It has a longer vascular pedicle and provides tissue coverage of similar quality as that of normal glabrous skin but not sacrifice the digital artery.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• the injured and adjacent fingers are unable to be used as the donor due to multiple digital injuries
• a soft tissue defect > 1.5 cm in length with exposed bone or tendon
• the reverse DMA flap may not be appropriate for tissue reconstruction due to the concomitant injuries or due to the limitation of the rotation arc
• a patient between 15 and 60 years of age

Exclusion Criteria

• concomitant injuries involved all the finger that precluded their use as donor sites
• a defect less than 1.5 cm in length
• injuries to the course of the vascular pedicle

• Minimum Eligible Age: 15 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Chinese PLA General Hospital

OTHER

Sponsor Role: collaborator

The Second Hospital of Tangshan

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

The Second Hospital of Tangshan

Tangshan, Hebei, China

Countries

China

References

Yang D, Morris SF. Reversed dorsal digital and metacarpal island flaps supplied by the dorsal cutaneous branches of the palmar digital artery. Ann Plast Surg. 2001 Apr;46(4):444-9. doi: 10.1097/00000637-200104000-00017.

Reference Type: RESULT

PMID: 11324891 (View on PubMed)

Chen C, Zhang W, Tang P. Direct and reversed dorsal digito-metacarpal flaps: a review of 24 cases. Injury. 2014 Apr;45(4):805-12. doi: 10.1016/j.injury.2013.11.002. Epub 2013 Nov 13.

Reference Type: DERIVED

PMID: 24315482 (View on PubMed)

Other Identifiers

CHS130-00215

Identifier Type: OTHER

Identifier Source: secondary_id

HBTS1308112

Identifier Type: -

Identifier Source: org_study_id