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. 2022 Jun 21;17(1):326.
doi: 10.1186/s13018-022-03214-1.

Parallelogram flap versus homodigital island flap in the treatment of fingertip defects with bone exposure: a prospective controlled study

Yingkai Zhang #  1   2 , Yao Wang #  1 , Xianwei He  1 , Jiaqi Zhou  1 , Guoping Cai  3 , Rongbo Wu  4
Affiliations

Parallelogram flap versus homodigital island flap in the treatment of fingertip defects with bone exposure: a prospective controlled study

Yingkai Zhang et al. J Orthop Surg Res. .

Abstract

Purpose: A modified local transposition flap (we call it "parallelogram flap") surgery was performed for fingertip injuries. This study aimed to compare the clinical effects of parallelogram flap and homodigital island flaps in fingertip reconstruction.

Methods: The study collected patients who underwent parallelogram transposition flaps and homodigital island flaps to repair fingertip defects from 2019 to 2021. 150 cases (150 fingers) were included in our study. All operations were performed by one surgical team. Record the operation time, two-point discrimination (2PD), Total Active Movement (TAM) and the MHQ (Michigan Hand Questionnaire) of the injured fingers to evaluate the therapeutic effect.

Results: All parallelogram (Group A) and homodigital island flap (Group B) had survived postoperatively. The operative duration of Group A (31.2 ± 3.3 min) is shorter than Group B (97.8 ± 6.1 min) (P < 0.05). At the 6-month follow-up, there was no difference with the two-point discrimination (2PD) of the palmar part of the flaps and the Total Active Movement (TAM) of injured figures in Group A and Group B. The MHQ summary scores in Group A (94.29 ± 3.14) were much higher than in Group B (91.73 ± 3.41) (P < 0.05). Evaluation of the MHQ subscale performance showed that the overall hand function, activities of daily living, work performance and pain score had no differences(P > 0.05), but aesthetics (92.15 ± 7.16) and satisfaction (92.45 ± 5.61) score in Group A was higher than aesthetics (86.56 ± 5.60) and satisfaction (86.72 ± 8.21) score in Group B (P < 0.05 for both).

Conclusions: The reconstruction using parallelogram flaps is a easier and more versatile treatment with better functions, less morbidity and better aesthetics. This method is a better choice for reconstruction of fingertip injury.

Keywords: Bone exposure; Coverage; Defect; Fingertip; Local Flaps; Trauma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PNB356 finger amputation injuries
Fig. 2
Fig. 2
Surgical steps of the parallelogram flap: a A longitudinal incision was made along the bone surface on both sides of the fingertip and the incised position should not exceed the transverse striation of the distal interphalangeal joint. b A transverse incision was made on the side with more remaining skin to provide sufficient angle for flap turnover. c A piece of skin graft A was left on the opposite side and to fill the defect B. d The parallelogram flap reconstruction and skin grafts are completed
Fig. 3
Fig. 3
Schematic drawing of the parallelogram flap: The red represents the injured finger, and the black represents the parallelogram flap. The longest hypotenuse c should be longer than the longitudinal length a + the width of defect b
Fig. 4
Fig. 4
Intraoperative performance: Patients treated by homodigital island flaps
Fig. 5
Fig. 5
Intraoperative performance: Patients treated by parallelogram flaps A, B Postoperative performance C, D, E The procedure of surgery F, G four month after surgery
Fig. 6
Fig. 6
Intraoperative performance: Patients with bone exposure treated by parallelogram transposition flaps. A, B Postoperative performance C The procedure of surgery D four month after surgery
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References

    1. Abbase EA, Tadjalli HE, Shenaq SM. Fingertip and nail bed injuries. Postgrad Med. 1995;98(5):217–236. doi: 10.1080/00325481.1995.11946081. - DOI - PubMed
    1. Tang JB, Elliot D, Adani R, Saint-Cyr M, Stang F. Repair and reconstruction of thumb and fingertip injuries: a global view. Clin Plast Surg. 2014;41(3):325–359. doi: 10.1016/j.cps.2014.04.004. - DOI - PubMed
    1. Holm A, Zachariae L. Fingertip lesions an evaluation of conservative treatment versus free skin grafting. Acta Orthop Scand. 1974;45(3):382–392. doi: 10.3109/17453677408989160. - DOI - PubMed
    1. Kleinman WB, Dustman JA. Preservation of function following complete degloving injuries to the hand: use of simultaneous groin flap, random abdominal flap, and partial-thickness skin graft. J Hand Surg Am. 1981;6(1):82–89. doi: 10.1016/S0363-5023(81)80017-2. - DOI - PubMed
    1. Bevin AG, Chase RA. The management of ring avulsion injuries and associated conditions in the hand. Plast Reconstr Surg. 1963;32:391–400. doi: 10.1097/00006534-196310000-00001. - DOI - PubMed