Clinical Application of a Modified Local Transposition Flap Surgery in Repairing Fingertip Defects

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Abstract Background: A modified local transposition flap surgery was performed for fingertip injuries, which allows a more significant transfer distance with good outcomes.Methods: The study collected patients who underwent parallelogram transposition flaps and V-Y flaps to repair fingertip defects from 2017 to 2020. 122 cases (122 fingers) were included in our study, The interval between the injury and operation was 5.78 h (the mean value was 4.7-8.4 h). All operations were performed by one surgical team, and the average operation time was 31.2 min.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 V-Y flaps （Group B）had survived postoperatively. There was no difference with operative duration and follow-up time in two groups. At last follow-up, there was no difference with the 2PD of the palmar part of the flaps and the TAM of injured figures in Group A and Group B . The MHQ summary scores in Group A were much higher than in Group B . Evaluation of the MHQ subscale performance showed that the overall hand function, activities of daily living, work performance and pain score had no differences, but aesthetics and satisfaction score was higher in Group A .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.

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