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KMID : 0358820110380050663
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Journal of Korean Society of Plastic and Reconstructive Surgeons
2011 Volume.38 No. 5 p.663 ~ p.668
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A Modified Free Thenar Flap with Constant Innervations and Its Clinical Application
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Han Seung-Kyu
Yang Jae-Won
Kim Jin-Soo
Lee Dong-Chul
Ki Sae-Hwi
Roh Si-Young
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Abstract
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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.
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KEYWORD
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Sensate flap, iRASP flap, Innervated free thenar flap, Free thenar flap, Sensory outcome
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