SURGICAL TECHNIQUE: Harvesting of an adipocutaneous flap from the dorsum of the finger to the midlateral line, preserving the paratenon of the donor phalanx. See also: technique Thumb opposition requires the action of several muscles, those responsible for positioning the thumb and those providing compressive forces for pinch. Ganga Hand & Microsurgery Operative Course | Live Virtual ... Download pdf. A full-thickness graft can be taken to close the donor finger dorsum. Twelve patients with mechanical distal thumb degloving injuries were treated between February 2017 and August 2019. Innervated Cross-Finger Pulp Flap for ... - CORE in issue. Cross finger flap technique The flap is elevated from the adjacent finger dorsum in the plane above the peritenon to allow for grafting of the donor site. To preserve finger length and function, flap transplantation rather than skin graft is usually performed to reconstruct the defective soft tissue. 74 Cross Finger (and Reverse) Flap | Plastic Surgery Key Contents sate flap (12). 16. Another indication of the cross-finger flap is for more distal defects in which more tissue is required for coverage than . ② A two-stage operation is required to implement the cross-finger or thenar flap. The homodigital island flap is a wellestablished technique for fingertip reconstruction. The skin in this finger was indurated and tight secondary to the recent trauma and wound breakdown, leaving no slack for the use of a rotation flap, which allows direct closure of the donor site. Cross-Finger Flap. ASSH Surgical Anatomy: Flap Reconstruction - Videos Video 2-1: Reconstruction of a fingertip amputation and pulp defect using a thenar flap Guang Yang, MD, Kevin C. Chung, MD, MS Video 3-1: Cross-finger flap technique Peter Charles Rhee, DO, MS Video 3-2: Reverse cross-finger flap technique Peter Charles Rhee, DO, MS The conventional cross finger flap is an established technique and is well suited for intermediate-sized partial pulp losses. A new approach "Double Cross-Finger Flaps" was used for coverage of ring avulsion injuries. Transection of the flap pedicle after 14-21 days. Microsurgery. ① The advancement distance of the V-Y advancement flap is generally no more than 1.0 cm. [4] Among these flaps, FDMA flap is a reliable flap for . Proper flap coverage is important for preserving finger length and appearance [].Surgical techniques are required to meet aesthetic and functional needs and provide maximum protection of the donor site, with a low complication rate [2, 3].When restoring the appearance and function of the fingers, hand . The Hueston flap in reconstruction of fingertip skin loss: results in a series of 41 patients. Darrach ECU FCU Tenodesis. By Semih Takka. Donor site problems an joindt contractures were infrequen seriet in this osf 150 thenar flaps. Currently, there are several kinds of flaps available for covering defects of the fingers, like V-Y advancement flaps, rotation flaps, and cross-finger flaps [3, 4]. A cross-finger flap based on the dorsal branch artery (DBA) including sensory nerve is a useful reconstructive technique.In our modification, the innervated sensory flap is vascularized by the DBA, both its pedicle is narrow and its coverage is extended, the projecting tip of exposed distal phalanx of adjacent digits therefore can be wrapped. Immobilization of both fingers until the pedicle is transected. TECHNIQUE A well executed cross-finger flap does requir~ a more formal operative setting than the emer-gency department. Brachial Plexus Exploration & Nerve Transfer. Sucur et al. The reposition flap technique is simple to perform with a mean operating time of 51 min in our study. partial toe transfer, ADP free flap, free groin flap can be used but such a technique requires microsurgical experience and prolonged operative time. Despite somedisadvantages, cross-finger pulp flap is a relatively simple procedure without significantcomplications or requiring special techniques.Methods This study included 90 patients with fingertip defects who underwent cross-fingerpulp flap between September 1998 and March 2010. Reconstruction using an advancement flap, cross-finger flap, and an innervated cross-finger pulp flap are very popular, and pedicled flap within hand matches the texture of the fingertips very closely, the loss of the main pedicle is a major drawback of this reconstruction technique. Local flap coverage like V-Y pasty, [4,5] Volar advancement flap [6,7&8] and cross-finger flap [9,10,11,12,13,14,15,16,17] and homodigital neurovascular flap.H8] In consultation with patient, every surgeon must choose the type of coverage that appears to be most appropriate for that individual's need. technique. Methods. PLEASE VISIT WWW.UWHAND.COM FOR MORE INFORMATION ON THE UW HAND CENTER.A reverse cross finger flap is indicated in adults with defects on the dorsum of the f. Vol. Background. after 7-10 days, soaks in water-peroxide solution daily followed by application of soft dressing and fingertip protector. Chao Chen, Peifu Tang, Lihai Zhang, Bin Wang, Treatment of Fingertip Degloving Injury Using the Bilaterally Innervated Sensory Cross-Finger Flap, Annals of Plastic Surgery, 10.1097/SAP.0b013e31828d7258, 73, 6, (645-651), (2014). The conventional cross finger flap is an established technique and is well suited for intermediate-sized partial pulp losses. The reverse cross finger flap is indicated in these situations: 1. It is claimed that this gives near normal restoration of sensation to the tactile surface of the thumb. Background: Cross-finger flaps, over time, have become the one of the best reconstructive method in order to reconstruct fingers with significant soft tissue loss. Cross-Finger Flap. Anatomy; Surgical Technique. Contraindications: Extensive tissue defects crossing the finger joints. Anterior Trunk Flap Options; DORSAL TRUNK. See also: cross flap . In our study, we demonstrated the effectiveness of reposition cross finger flap technique in motorcycle spokes wheel injuries with good pulp contour. cross-finger flap: a flap designed on the volar or (more commonly) dorsal surface of one finger and used to reconstruct the opposing surface of an adjacent finger or the thumb of the same hand. advancement flap,[3] Moberg advancement flap,[1,4] cross-finger flap,[2,5] Littler's neurovascular island flap,[1,6] first . ③ In the digital artery island flap technique, a major ar-tery is compromised. 10.1055/b-0040-177489 74 Cross Finger (and Reverse) FlapJustin M. Miller, John M. Yingling, and John T. Capo Abstract The cross-finger flap and reversed cross-finger flaps are utilitarian techniques for obtaining soft tissue coverage of phalangeal defects. Related Papers. The reverse adipofascial cross finger flap was covered with split thickness skin graft. To examine the efficacy of combination of the reverse dorsoradial flap of the thumb and middle finger proper digital arterial island flap for repair of distal thumb degloving injury. Extremity Flap Reconstruction. Surface Landmarks; Flap Elevation; Reverse Cross-Finger Flap; Innervated Cross-Finger Flap; References; PART III Clinical Applications: Trunk. A new approach "Double Cross-Finger Flaps" was used for coverage of ring avulsion injuries. - Cross finger flap - Thenar flap - Radial forearm flap - Posterior interosseous flap - Groin flap . Cross-finger (described by Gurdin and Pangman in 1950) and thenar flap Used for volar oblique, substantial pulp tissue loss, and multiple fingertip injuries Disadvantage is use of two stage procedure and stiffness from prolonged immobilization Contraindicated in pts with RA, DM, and vasospastic disorders The patient had full range of a women) - Advantages: - more subcutaneous fat available than cross finger flap. Two cross-finger flaps were harvested, one to cover the . VENTRAL TRUNK. In our series, 22 cases of ring avulsion injuries were operated upon by this new technique. Full thickness skin grafting from hypothenar region. crossed finger technique: A hazardous method of opening an unconscious patient's mouth by placing the thumb and index finger of a gloved hand on opposite rows of teeth and spreading the jaw open. Transection of the flap pedicle after 14-21 days. Amongst all these, the FDMA flap is a versatile flap for covering distal thumb defects on dorsal or volar aspects (Kodi K Azari Three weeks later this flap was divided and the thumb was mobilized freely. The flap is commonly harvested from the adjacent finger due to its ease of positioning. ② A two-stage operation is required to implement the cross-finger or thenar flap. Wound Coverage Techniques for the Injured Extremity Gil Ortega, MD, MPH . Access Options. The fingers may be treated in the same way for similar injuries. complete healing takes 3-5 weeks. The conventional cross finger flap is an established technique and is well suited for intermediate-sized partial pulp losses. Similarly, the reverse digital artery flap from the Therefore, finding a new repair Patients and methods: This study comprised of 21 patients with finger injuries with exposed vital structures . different uses of the flap and the modifications made in the technique. Reconstruction of an eponychial skinfold and coverage of an exposed extensor tendon near the IP joint. Fingertip reconstruction with flaps and nail bed grafts. Primary clo- sure, split-thickness skin grafting, orjust simple . In addition, long-term follow-up of cross-finger flap technique reported very good sensory recovery. Previous article. The thenar flap - an analysis of its use in 150 cases. 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