Determining Sensation Status in Advancement Pedicle flaps Following Thumb Amputation

Abstract

A crucial aspect in the treatment of thumb amputation is achieving the proper feel and adequate coverage of the soft tissue while preserving the remaining length. Ideally, a technique applicable in acute thumb injuries is sought, one that doesn't harm other fingers or body parts, restores sensation to the washed distal pulp, and ensures acceptable functionality. Among various surgical methods, the use of the Advancement-based flap, crafted from the damaged thumb itself, proves effective in covering the amputated part and restoring both feeling and function. This study aims to evaluate the sensory state of Advancement Pedicle flaps following thumb amputation. Materials and Methods: In this cross-sectional descriptive study, 46 patients with thumb amputation and associated soft tissue defects, particularly on the volar surface, with or without bony defects, distal to the interphalangeal joint were selected from Shahada Hospital. These patients underwent advancement pedicle flap surgery, involving lateral incisions on the thumb. Post-surgery, sensory conditions of the treated finger were measured during subsequent visits, comparing them with the healthy side finger using 2-point discrimination. Concurrently, the function of the treated finger was assessed in comparison to the healthy finger. Results: Among the 46 participants in the study, it was observed that the count of individuals with excellent sensory status increased from two during the initial visit to 26 during the final visit. Furthermore, the number of individuals with severe sensory disorders decreased from 18 in the first visit to three in the last visit (P<0.05). Additionally, there were no individuals with excellent performance status during the first visit, but by the last visit, this number had risen to six. Similarly, the number of individuals with severely impaired functional status decreased from 38 in the first visit to five in the last visit (P < 0.05).