Radial nerve cross-finger flap differential nerve contribution in thumb reconstruction |
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Authors: | M A Walker C B Hurley J W May |
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Affiliation: | From the Division of Plastic and Reconstructive Surgery and Hand Surgery Service, and the Department of Physical Therapy, Massachusetts General Hospital, Boston, Mass.;Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão, Brazil;Governador Celso Ramos Hospital, Department of Orthopedic Surgery, Florianópolis, Brazil;Centre de la Main, Angers Assistance Main, 47, rue de la Foucaudière, 49800 Trélazé, France |
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Abstract: | Six patients with extensive palmar thumb pulp and soft tissue loss were treated with a staged transfer of radial nerve innervated flap tissues from the dorsum of the index finger. They were followed for a mean period of 3 years. This transfer of radial nerve innervated dorsal index finger tissues to the palmar surface of the thumb has been a successful method of innervation restoration. The ultimate sensibility of the reconstructed thumb seems to be a mixture of median and radial nerve sensibility. Sensory testing shows that after transfer, the ulnar side of the flap is more innervated from the radial nerve than the radial side. Our findings suggest that the presence of active sensory axons in the radial nerve innervated flap may play an inhibitory role in direct and/or functional neurotization of the transferred flap. |
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