Background: Reverse homodigital dorsoradial (RHD) flap has been developed to repair soft-tissue defects of the thumb. However, few articles have reported this flap with long-term follow-up. This retrospective study was designed to evaluate the RHD flap and investigate factors affecting sensory recovery.
Methods: From February 2010 to February 2011, 19 patients were treated consecutively with RHD flap without neurorrhaphy. At final follow-up, flap sensibility was assessed by Semmes-Weinstein (SW) monofilament, moving two-point discrimination (M-2PD), and static two-point discrimination (S-2PD) tests. Patient satisfaction, active range-of-motion of the joints, patient complications, and cold intolerance severity score questionnaire were sequentially evaluated. The patients were divided into two groups based on the S-2PD results and another two groups based on flap size.
Results: The mean SW monofilament sensitivity and M-2PD and S-2PD scores on the flap were 4.01 g and 9.26 mm, and 10.63 mm, respectively. Highly positive correlations existed between the flap size and the M-2PD and S-2PD scores. Moreover, in the respective groups based on S-2PD scores and flap size, no statistical difference was found among age, sex, and follow-up time, but the flap size and S-2PD scores were statistically different.
Conclusions: RHD flap without neurorrhaphy is a recommendable technique for relatively small-sized thumb-defect reconstruction, which can achieve a satisfactory sensory recovery.
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