Abstract
Background
Fingertip amputations are common injuries of the hand and their surgical treatment can be challenging due to their unique structure, composite content, and scarcity of available tissue. We describe the double wing transposition flap, a new technique for fingertip reconstruction, and report 1-year outcomes.
Methods
This is a retrospective study of patients who underwent a double wing transposition flap for fingertip reconstruction following amputation. Data with regards to the injured digit, size of the defect, level of amputation (Ishikawa), and plane of amputation was recorded. Any early complications of surgery were documented. The outcomes measured included time to return to work/ normal activities, the arc of motion at the distal interphalangeal joint (DIPJ), two-point discrimination (2-PD), and late complications like cold intolerance, pain, and nail deformity.
Results
A total of 46 patients (mean age: 28 years; 38 men and 8 women) with 46 fingertip amputations were reconstructed with a double wing transposition flap. The mean defect size was 2.2 × 1.9 cm. There were no partial or total flap losses. The mean arc of motion at the DIPJ was 73°, and the mean 2-PD was 4.8 mm. A total of 8 patients had a hook nail deformity. No patient complained of pain or cold intolerance.
Conclusions
The double wing transposition flap is a simple procedure for fingertip reconstruction. It can be done relatively fast, which does not need dissection of the neurovascular pedicles, and can be used in the reconstruction of transverse, volar oblique, and dorsal oblique fingertip amputations.
Level of evidence: Level IV, Therapeutic study.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Due the retrospective nature of the study, it was exempted from ethical approval by The Human Investigation Committee (IRB) of Adimayan University Faculty of Medicine (Doc. No: E-53911808-903-2698).
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Doğan, F. New technique for the reconstruction of the finger tip amputation: the double wing transposition flap. Eur J Plast Surg 46, 245–250 (2023). https://doi.org/10.1007/s00238-022-02015-3
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DOI: https://doi.org/10.1007/s00238-022-02015-3