Reconstruction of two fingertip amputations using a double thenar flap and comparison of outcomes of surgery using a single thenar flap

Abstract

Background: Although thenar flap for single fingertip amputation is a common and popular surgical technique double thenar flap technique for patients with two fingertip amputations has rarely been reported in the literature. The purpose of this case control study was to introduce the double thenar technique and compare the clinical outcomes between single thenar flap and double thenar flap surgical treatments. Methods: From January 2005 to December 2014 92 patients with single fingertip amputations were treated with thenar flap (Group I) and 28 patients with two fingertip amputations were treated with double thenar flap (Group II). These 120 patients were followed up for a minimum of 12 months postoperatively. At the latest follow up the two groups were assessed for pain cold intolerance in the reconstructed finger functional outcomes by Chen's criteria and subjective patient satisfaction. Results: At the final follow up all flaps in both groups had survived. No flap failure occurred. There was no significant difference in cold intolerance (p = 0.783) donor site pain (p = 0.728) fingertip pain (p = 1.000) or paresthesia (p = 0.514) between the two groups. A total of 100 (83.3%) patients were completely or fairly satisfied. There was no significant difference in satisfaction between the two groups (p = 0.801). According to the Chen criteria 102 (85%) patients had excellent or good results. Conclusion: This study demonstrated that the double thenar flap technique used for patients with two fingertip amputations produced complete survival with functional outcomes comparable to those of the single thenar flap technique at the last follow up. (C) 2016 Elsevier Ltd. All rights reserved.