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Research Article
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Year 2022, Volume: 44 Issue: 4, 455 - 459, 31.12.2022

Bülent Özdemir , Tarık Elma

https://doi.org/10.7197/cmj.1201371

Abstract

References

  • 1. Li YS, Chen CY, Yang SW, Tarng YW. Cross-finger subdermal pocketplasty as a salvage procedure for thumb tip replantation without vascular anastomosis: a case report. J Int Med Res. 2018;46(9):3717-23.
  • 2. Jazayeri L, Klausner JQ, Chang J. Distal digital replantation. Plast Reconstr Surg. 2013;132:1207–17.
  • 3. Koh SH, Park I, Kim JS, Lee DC, Roh SY, Lee KJ, Hong MK. Fingertip reconstruction with a subcutaneous flap and composite graft composed of nail bed and volar pulp skin. Arch Plast Surg. 2022;49(1):70-5.
  • 4. Streit L, Streit L, Dvorak Z, Novak O, Stiborova S, Vesely J. The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient. Acta Chir Plast 2014;56(1–2):23–6.
  • 5. Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):8291.
  • 6. Germann G, Rudolf KD, Levin SL, Hrabowski M. Fingertip and thumb tip wounds: changing algorithms for sensation, aesthetics, and function. J Hand Surg Am. 2017;42(4):274-84.
  • 7. Tang JB, Elliot D, Adani R, Saint-Cyr M, Stang F: Repair and reconstruction of thumb and finger tip injuries: a global view. Clin Plast Surg. 2014, 41:325-59.
  • 8. Rehim SA, Chung KC. Local flaps of the hand. Hand Clin. 2014;30:137–51.
  • 9. Lemsanni M, Najeb Y, Chaouqui Y, Elkasseh M, Zoukal S. Fingertip injuries managed by a thenar flap: Follow-up and long-term outcomes of 32 cases. Hand Surg Rehabil. 2021;40(4):484-90.
  • 10. Panattoni JB, De Ona IR, Ahmed MM. Reconstruction of fingertip injuries: surgical tips and avoiding complications. J Hand Surg Am. 2015;40(5):1016-24.
  • 11. Atasoy E,Ioakimidis E,Kasdan ML,Kutz JE,Kleinert HE. Reconstruction of the amputated finger tip with a triangular volar flap. A new surgical procedure. J Bone Joint Surg Am. 1970;52(5):921-6.
  • 12. Thoma A, Vartija LK. Making the V-Y advancement flap safer in fingertip amputations. Can J Plast Surg. 2010;18(4):47-9.
  • 13. Henderson JT, Schulz SA, Swiergosz AM, Andrea R Hiller AR, Gunn JS, Choo JH, Kasdan ML, Wilhelmi BJ. Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap. Eplasty. 2017;17:28.
  • 14. Zook EG. The perionychium: anatomy, physiology, and care of injuries. Clin Plast Surg. 1981;8(1):21-31.
  • 15. Zook EG. Complications of the perionychium. Hand Clin. 1986;2(2):407-27.
  • 16. Guy RJ. The etiologies and mechanisms of nail bed injuries. Hand Clin. 1990;6(1):9-19.
  • 17. Lim JX, Chung KC. VY Advancement, Thenar Flap, and Cross-finger Flaps. Hand Clin. 2020;36(1):19-32.
  • 18. Louis DS, Jebson PJL, Graham TJ. Amputations. In: Green D, Hotchkiss RN, Pederson WC, editors. Green’s operative hand surgery. 4th ed., Philadelphia,PA: Elsevier/Churchill Livingstone; 1993:54–5.
  • 19. Foo TL, Wan KH, Chew WY. Safe and easy method to preserve fingertip contour in VY-plasty. Tech Hand Up Extrem Surg. 2012;16(2):95–7.

Fingertip Amputations Repair with V-Y Flap and Polyethylene Nail

Year 2022, Volume: 44 Issue: 4, 455 - 459, 31.12.2022

Bülent Özdemir , Tarık Elma

https://doi.org/10.7197/cmj.1201371

Abstract

Background: Finger amputations are the most commonly encountered amputation injury in the upper extremities. It is important to avoid shortening and to preserve the length of the finger in fingertip amputations in order not to lose the functions of the hand. The aim of this study was to evaluate the results of our patients who underwent reconstruction using V-Y pulp flap and artificial nail in order to avoid donor site morbidity in fingertip defects.
Methods: The results of patients who underwent reparation with V-Y flap and polyethylene nails for exposed distal phalanx and partial nail bed defect after fingertip amputation were evaluated in this retrospective study. The data of 44 patients who underwent 44 V-Y advancement flap between January 2016 and January 2021 were retrospectively analysed.
Results: A total of 44 patients, 5 females and 39 males, who were treated for fingertip amputation, with a mean follow-up period of 24.2 months (14-71) and a mean age of 34.75 (2-68) were included in the study. The mechanism of injury was guillotine-style, avulsion and crush injuries in 15 (34.1%), 11 (25%) and 18 (40.9%) patients, respectively. Among the patients, 25 (56.8%) had right hand injuries, while 19 (43.2%) had left hand injuries. The dominant hand was affected in 28 (63.6%) patients. In 5 patients, the distal phalanx was shortened to the level of the lost nail bed (shortening was maximum 5 mm). Nail formation had occurred in all patients and deformed nail structure was seen in 18 patients. Graft necrosis was seen in 2 patients.
Conclusion: It is difficult for surgeons to decide on the treatment method because of the fact that there are multiple surgical techniques in the literature and the results are reported differently. Success rates are high in our technique. Each technique has its own advantages and disadvantages.

Keywords

Amputation Digit Finger V-Y Flap Nail Finger Tip

References

  • 1. Li YS, Chen CY, Yang SW, Tarng YW. Cross-finger subdermal pocketplasty as a salvage procedure for thumb tip replantation without vascular anastomosis: a case report. J Int Med Res. 2018;46(9):3717-23.
  • 2. Jazayeri L, Klausner JQ, Chang J. Distal digital replantation. Plast Reconstr Surg. 2013;132:1207–17.
  • 3. Koh SH, Park I, Kim JS, Lee DC, Roh SY, Lee KJ, Hong MK. Fingertip reconstruction with a subcutaneous flap and composite graft composed of nail bed and volar pulp skin. Arch Plast Surg. 2022;49(1):70-5.
  • 4. Streit L, Streit L, Dvorak Z, Novak O, Stiborova S, Vesely J. The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient. Acta Chir Plast 2014;56(1–2):23–6.
  • 5. Kawaiah A, Thakur M, Garg S, Kawasmi SH, Hassan A. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):8291.
  • 6. Germann G, Rudolf KD, Levin SL, Hrabowski M. Fingertip and thumb tip wounds: changing algorithms for sensation, aesthetics, and function. J Hand Surg Am. 2017;42(4):274-84.
  • 7. Tang JB, Elliot D, Adani R, Saint-Cyr M, Stang F: Repair and reconstruction of thumb and finger tip injuries: a global view. Clin Plast Surg. 2014, 41:325-59.
  • 8. Rehim SA, Chung KC. Local flaps of the hand. Hand Clin. 2014;30:137–51.
  • 9. Lemsanni M, Najeb Y, Chaouqui Y, Elkasseh M, Zoukal S. Fingertip injuries managed by a thenar flap: Follow-up and long-term outcomes of 32 cases. Hand Surg Rehabil. 2021;40(4):484-90.
  • 10. Panattoni JB, De Ona IR, Ahmed MM. Reconstruction of fingertip injuries: surgical tips and avoiding complications. J Hand Surg Am. 2015;40(5):1016-24.
  • 11. Atasoy E,Ioakimidis E,Kasdan ML,Kutz JE,Kleinert HE. Reconstruction of the amputated finger tip with a triangular volar flap. A new surgical procedure. J Bone Joint Surg Am. 1970;52(5):921-6.
  • 12. Thoma A, Vartija LK. Making the V-Y advancement flap safer in fingertip amputations. Can J Plast Surg. 2010;18(4):47-9.
  • 13. Henderson JT, Schulz SA, Swiergosz AM, Andrea R Hiller AR, Gunn JS, Choo JH, Kasdan ML, Wilhelmi BJ. Preservation of the Sterile Matrix, Hyponychium, and Fingertip Pad in Fingertip Reconstruction With Composite Fingertip and Nail Bed Graft and Volar V-Y Advancement Flap. Eplasty. 2017;17:28.
  • 14. Zook EG. The perionychium: anatomy, physiology, and care of injuries. Clin Plast Surg. 1981;8(1):21-31.
  • 15. Zook EG. Complications of the perionychium. Hand Clin. 1986;2(2):407-27.
  • 16. Guy RJ. The etiologies and mechanisms of nail bed injuries. Hand Clin. 1990;6(1):9-19.
  • 17. Lim JX, Chung KC. VY Advancement, Thenar Flap, and Cross-finger Flaps. Hand Clin. 2020;36(1):19-32.
  • 18. Louis DS, Jebson PJL, Graham TJ. Amputations. In: Green D, Hotchkiss RN, Pederson WC, editors. Green’s operative hand surgery. 4th ed., Philadelphia,PA: Elsevier/Churchill Livingstone; 1993:54–5.
  • 19. Foo TL, Wan KH, Chew WY. Safe and easy method to preserve fingertip contour in VY-plasty. Tech Hand Up Extrem Surg. 2012;16(2):95–7.
There are 19 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Surgical Science Research Articles
Authors

Bülent Özdemir 0000-0003-2829-7849

Tarık Elma 0000-0003-4800-3983

Publication Date December 31, 2022
Acceptance Date December 25, 2022
Published in Issue Year 2022 Volume: 44 Issue: 4

Cite

AMA Özdemir B, Elma T. Fingertip Amputations Repair with V-Y Flap and Polyethylene Nail. CMJ. December 2022;44(4):455-459. doi:10.7197/cmj.1201371