Mehmet YAZAR, Atakan AYDIN, Sevgi YZAR KURT, Karaca BAŞARAN, Erdem GÜVEN

Parmak ucu rekonstrüksiyonunda ters akımlı homodijital ada flebinin duyu geri dönüş sonuçları: 66 vakalık seri sunumu

Amaç: Parmak ucu, konumu nedeniyle fonksiyonel ve estetik öneme sahip olduğu gibi elin travmalara en duyarlı bölgesidir. Rekonstrüksiyon aşamasında parmak uzunluğu ve fonksiyonunun korunması, eklem sertliği ve nöroma oluşumunun engellenmesi ve kozmetik olarak kabul edilebilir bir görünümün elde edilmesi gerekir. Özellikle kemik, tendon veya eklemin açıkta olduğu vakalarda parmak ucu restorasyonu için değişik şep seçenekleri tanımlanmıştır. Bu seçeneklerden biri de ters akımlı homodijital ada şebidir. Bu çalışmada acil el cerrahisi kliniğimize parmak ucu yaralanması yla başvuran 66 hastadaki ters akımlı homodijital ada şebinin takip dönemindeki duyu geri dönüş sonuçlarını sunmaktayız. Çalışma planı: Çalışmaya parmak ucu amputasyonu olan 66 hasta (70 parmak) dahil edildi ve hastalara ters akımlı homodijital ada şebi uygulandı. Hastaların takip süresinde 6., 12. ve 18. aylarda Semmes-Weinstein monofilaman testi ve iki-nokta ayrım testi ile duyu geri dönüşleri değerlendirildi ve komplikasyonlar kaydedildi. Sonuçlar: Monofilaman testi sonuçlarına göre 64 parmakta normal duyu (%91.4), altı parmakta ise azalmış hafif dokunma saptandı. iki-nokta ayrım testi sonuçları ise 40 parmakta normal (

Sensory recovery of the reverse homodigital island flap in fingertip reconstruction: A review of 66 cases

Objectives: The location of the fingertip entitles it to have significant cosmetic and functional values, but also places it at high risk for injury. During repair, finger length and function should be maintained, and stiffness and neuroma should be avoided. Various flaps have been described for reconstruction of distal finger defects with bone, tendon, or joint exposures, including reverse flow homodigital island flap. In this study, we present our experience of reverse flow homodigital island flap in terms of sensory recovery. Methods: Sixty-six patients (70 fingers) with fingertip amputations were included in the study. Patients were treated with homodigital island flaps. All patients underwent sensitivity assessment by 2-point discrimination and Semmes-Weinstein monofilament tests at 6, 12, and 18 months during follow-up, and complications were recorded. Results: Monofilament testing results were normal in 64 fingers (91.4%), and diminished light touch was found in six fingers. Two-point discrimination results were normal (<6 mm) in 40 fingers and fair (6-10 mm) in 30 fingers (mean 5.7 mm, range 4-9 mm). Complications included one partial flap necrosis, three flexion contractures, and two neuromas. Conclusion: In repair of injuries to areas in which sensory feedback is critical, such as the index finger, the homodigital flap may be the treatment of choice.

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