A Comparative Study of Cross Finger Flap with Thenar Flap for Finger Tip Reconstruction

Abstract

Introduction: Fingertip injuries are common hand injuries ranging from simple
laceration to larger defects with amputations. Different methods are used to
reconstruct the affected finger. Cross finger flaps and thenar flaps are commonly
used but it is difficult to select among these two flaps to reconstruct the finger in
our settings.

Method: This is a time-bound prospective comparative study conducted in 14
months duration. The aesthetic (sensibility, appearance and function as subjective
assessment) and functional outcomes (2 point discrimination and range of motion)
were measured. Data were analyzed using SPSS version 21. Overall significance
level was maintained at ‘p’ value < 0.05.

Results: There was female predisposition with average age of 34.66 years. The
common mode of injury was crush injury with right hand most commonly involved
hand and middle finger being commonly injured digit. On subjective assessment,
the difference on rating scale on sensibility, function and appearance was not
statistically significant among two groups. There were statistical significant
differences in mean of static and moving 2 point discrimination among thenar
flap and cross finger flap. . The mean active range of motion at three types of
joint (MP, PIP, DIP) of finger were 97.660, 82.660 and 38.660 in thenar group
and 88.330, 78.660 and 33.660 in cross finger group respectively which were not
statistically significant.

Conclusion: Our study does not find any precise characteristics for the selection
of thenar and cross finger flap based on aesthetic and functional outcomes in
reconstruction of fingertip injury.