Functional outcomes of local flap reconstruction in fingertip injury: a single-centre study

Abstract

Introduction: Various methods of local flap reconstruction for fingertip injury have been reported with no current consensus on the ideal option of management. Our study aimed at evaluating the functional outcomes of different flap reconstruction for fingertip injury in a single centre. Methods: From 2015 to 2021, 43 digits with local flap reconstruction performed in 41 patients in total were recruited into the study. Retrospective review of demographic data, injury details and short-term functional outcome was conducted using patient records. Long-term functional outcome was assessed by telephone interview in 31 patients with QuickDASH score. Objective sensory and motor assessments were performed in 14 digits. Results: Types of flaps included 25 volar advancement flaps, 7 bilateral V-Y flaps, 4 volar V-Y flaps 2 heterodigital island flaps, 2 homodigital island flaps, 1 cross finger flap, 1 lateral V-Y flap and 1 first dorsal metacarpal artery flap. Common complications included hook nail deformity (14.0%), wound infection (11.6%) and wound gaping (7.0%). There were no flap necrosis or failure. Mean percentage power grip and pincer grip were 73.1% and 63.2%, respectively upon discharge from therapy. For long-term functional outcome (at mean follow-up of 58.8 months), mean QuickDASH score was 7.48. Mean monofilament measurement at pulp centre is 4.37 and 28.6% of patients had 2-point discrimination within 5 mm. Mean percentage power grip and pincer grip were 106.9% and 88.0%, respectively. Conclusion: Local flap reconstruction in fingertip injury provides good functional outcome with high patient satisfaction.