Table 2.
Author (Year) | Reconstruction flap | Fingers involved | No. of patients (Followed up Vs total) | Defect size (mean)/ Type | Mean duration of follow-up (range) in months |
Mean two-point discrimination (mm)
Recipient/ contra-lateral finger |
Aesthetic outcomes | Complications | Other findings |
---|---|---|---|---|---|---|---|---|---|
Freiberg & Manktelow (1972) 7 | Kutler flap | - | 22/ 30 | - | - | 6/ - Light touch (excellent-2, good-8) Tactile gnosis (excellent-2, good-3, poor-2) |
- | Flap necrosis- 2 Infection- 2 Central dehiscence- 2 |
Hypersensitivity (mild)- 7 Numbness (mild)- 7 Cold sensitivity (mild-4, moderate-2) Paraesthesia- 3 |
Weston (1976) 9 | Triangular advancement flap | - | -/ 31 | - | - | - | Good results Kutler- 2/12 Median- 4/7 Half lateral- 5/11 |
- | Using finger normally- 23 Good functionally result-10 |
Gellis & Pool (1977) 8 | Kutler flap | - | - | - | - | 2.6/ - | - | - | - |
Atasoy flap | - | - | - | - | 3.1/ - | - | - | - | |
Frandsen (1978) 11 | Kutler flap | - | 14/16 | - | 32 (6-57) | Light touch missing- 0 | - | Tenderness on percussion- 10 Dysesthesia- 10 Curving of nail- 4 |
Coldness- 8 Difficulty in grasping objects- 6 Time of healing- 21 days Off work- 61 days |
Atasoy flap | - | 10/12 | - | 32 (6-57) | Light touch missing- 0 | - | Tenderness on percussion- 4 Dysesthesia- 7 Curving of nail- 3 |
Coldness- 4 Difficulty in grasping objects- 5 Time of healing- 21 days Off work- 29 days |
|
Tupper & Miller (1985) 10 | Volar VY plasty | - | 20/20 | - | 5.9 yr (1-11) | Difference in reconstructed and contralateral finger:
|
Patient satisfaction- 12 Average shortening- 7.6 mm (4.7- 12.5 mm) |
Parrot beaking- 3 Tenderness- 5 |
Difficulty in grasping small object- 10 Cryalgia- 12 |
Zhou et al (2015) 30 | Palmar VY flap combined with bone and nail bed graft | 14/14 | Allen Type II- 3 Type III- 7 Type IV- 5 |
12.8 (8-17) | 7.5 (4-12) | Fingertip length good and excellent- 78.6% Average subjective satisfaction score- 8.64 |
Dysesthesia- 0 | Cold intolerance- 14 Grip strength 10% lesser than corresponding digit MIPJ, PIPJ mobility loss <10% |
|
Haehnel et al (2019) 34 | Atasoy flap | Index- 6 Middle- 12 Ring- 3 Little- 6 Thumb- 3 |
30/47 | Ishikawa Subzone I- 8 Subzone II- 21 Subzone- III- 1 |
4.7 yr (1.3- 15.7) | Epicritical pulp tactile sensitivity
|
Normal pulp- 13 Striated nail- 4 Thicker nail- 15 Hyponychial scarring- 22 |
Hooknail deformity- 15 Pain- 9 |
Cold sensitivity- 12 |
Weighted mean | Kutler flap | 6 | - | Hook nail- 4/14 Pain- 10/14 |
Cold intolerance- 14/36 | ||||
Atasoy flap | 7.5 | - | Hook nail- 21/60 Pain- 18/60 |
Cold intolerance- 40/74 | |||||
Krishnan (2001) 13 | Pedicled VY flap | Index- 19 Middle- 14 Ring- 7 Little- 2 Thumb- 3 |
29/29 | Combination of Kutler and Atasoy system 1st-3rd degree |
3 (9-14 weeks) | 4.2+0.9 (1 month) 3.5+0.9 (3 months) p <0.0001 |
- | - | - |
Ozyigit et al (2007) 23 | Dorsal VY advancement flap | Index- 2 Middle- 1 Ring- 4 |
7/7 | Defect proximal to nail matrix (volar oblique/ transverse) | 18 (12-24) | 4.7 (4-5) | - | Dysesthesia/ paraesthesia- 0 Pain- 0 |
Return to work- 21 days Cold intolerance- 2 (on volar side) |
Sungur et al (2012) 25 | Bilateral VY rotation advancement flap | - | 7/7 | 1X0.4 cm to 2X1 cm | 18 (3-24) | <6 (same as contralateral finger) | - | No scar hypersensitivity | Cold intolerance- 0 Return to work- 1.5-2.5 weeks |
Diaz et al (2016) 31 | Double VY flap | - | 7/7 | Allen Type II- 1 Type III- 5 Type IV- 1 |
Minimum 6 months | 5 (4-6): proximal flap 8.43 (6-10): distal flap |
- | Infection- 0 Necrosis- o |
- |
Arpaci et al (2017) 32 | Super Kutler flap | - | 10/10 | 2.2X 1.8 cm | 12 (8-16) | 2PD- 3.5 mm (3-5) Semmes Weinstein test- 2.83 gm (2.44- 3.61) |
Michigan Hand Outcome Questionnaire Score 5- 7 Score 4- 3 |
Pain- 0 | CISS (Mild)- 3 Mean ROM:
|
Appukuttan & Ragoowansi (2020) 35 | Unilateral perforator VY flap (14-80 mm2) | Index- 3 Middle- 3 Little- 4 |
7/10 | Allen type III | 6 | 3- 4 | Aesthetically satisfied- 6 | Persistent sensitivity- 1 Parrot beaking- 1 |
- |