Repair of Multiple Finger Defects Using the Dorsal Homodigital Island Flaps

Multiple finger defects are common in hand trauma and result in functional disability. These injuries are often complex and severe, and thus reconstructive alternatives are limited. In this study, we use the dorsal homodigital island flaps, based on the dorsal branch of the digital artery, for reconstruction of multiple finger defects. At the final follow-up, we would evaluate the efficacy of this technique.

Study Overview

• Status: Completed
• Conditions: Soft Tissue Injuries; Finger Injuries
• Intervention / Treatment: Procedure: Soft tissue coverage

Detailed Description

At final follow-up, sensation of the flap and the donor site would be assessed using static two-point discrimination and Semmes-Weinstein monofilament testing. The range of motion of the proximal interphalangeal joint and the distal interphalangeal joint of the injured finger is measured by a goniometer. The cold intolerance of the injured finger is measured using the self-administered Cold Intolerance Severity Score questionnaire that is rated into mild, moderate, severe, and extreme. The pain of the injured finger and the donor site is given subjectively by the patient using the visual analogue scale, which ranges from 0 to 10 cm and groupes into mild (0-3 cm), moderate (4-6 cm) and severe (7-10 cm).

• Study Type: Interventional
• Enrollment (Actual): 12
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Hebei
    • Tangshan, Hebei, China, 063000
      • The Second Hospital of Tangshan

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 15 years to 60 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. a patient who had separate soft tissue defects in different fingers in same hand;
2. the defect ≥ 1.5 cm and ≤ 3.5 cm in length;
3. local tissue near the defect is uninjured; and
4. a patient between 15 and 60 years of age.

Exclusion Criteria:

1. concomitant injuries to local tissue around the defect that precluded its use as donor site;
2. a defect < 1.5 cm and ≥ 3.5 cm in length;
3. a finger degloving injury;
4. the defect of the thumb.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Surgical flap; Surgical flap is based on the dorsal branch of the digital artery, and is used for soft tissue coverageof multiple finger defects.	Procedure: Soft tissue coverage; The dorsal homodigital island flaps are used for soft tissue coverage of multiple finger defects

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
static two-point discrimination	The test points are at the center of the flap.Each area is tested 3 times with a Discriminator. We stopp at 4 mm as a limit of two-point discrimination and consider this normal.	postoperative 18-24 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cold intolerance of the injured finger	The cold intolerance of the injured finger was measured using the self-administered Cold Intolerance Severity Score questionnaire that was rated into mild, moderate, severe, and extreme.	Postoperative 18-24 months

Collaborators and Investigators

• Sponsor: The Second Hospital of Tangshan
• Collaborators: Chinese PLA General Hospital

Publications and helpful links

General Publications

• Hu HT, Chen WH, Liu WC, Hang QW. [Fingertip reconstruction using a volar flap based on the transverse palmar branch of the digital artery]. Zhonghua Zheng Xing Wai Ke Za Zhi. 2005 Sep;21(5):353-5. Chinese.
• Al-Qattan MM. Technical modifications and extended applications of the distally based adipofascial flap for dorsal digital defects. Ann Plast Surg. 2004 Feb;52(2):168-73. doi: 10.1097/01.sap.0000101954.16674.99.

Study record dates

Study Major Dates

• Study Start: March 1, 2008
• Primary Completion (Actual): August 1, 2011
• Study Completion (Actual): October 1, 2012

Study Registration Dates

• First Submitted: January 10, 2013
• First Submitted That Met QC Criteria: January 11, 2013
• First Posted (Estimate): January 14, 2013

Study Record Updates

• Last Update Posted (Actual): October 29, 2018
• Last Update Submitted That Met QC Criteria: October 25, 2018
• Last Verified: October 1, 2012

More Information

Terms related to this study

• Keywords: dorsal branch of the digital artery; surgical flap
• Additional Relevant MeSH Terms: Hand Injuries; Wounds and Injuries; Soft Tissue Injuries; Finger Injuries
• Other Study ID Numbers: HB-TS-0130067