Parallelogram flaps functionally better than homodigital island flaps for fingertip reconstruction

A modified local transposition flap ("parallelogram flap") surgery was performed for fingertip injuries by Zhang et al. The authors compared the clinical effects of parallelogram flap and homodigital island flaps in fingertip reconstruction. The study was conducted at Jinshan Hospital of Fudan University, Shanghai, People's Republic of China.

The study collected patients who underwent parallelogram transposition flaps and homodigital island flaps to repair fingertip defects. 150 cases (150 fingers) were included in the study. All operations were performed by one surgical team. Record the operation time, two-point discrimination (2PD), Total Active Movement (TAM) and the MHQ (Michigan Hand Questionnaire) of the injured fingers to evaluate the therapeutic effect.

The results of the study were:

• All parallelogram (Group A) and homodigital island flap (Group B) had survived postoperatively.

• The operative duration of Group A (31.2±3.3 min) is shorter than Group B (97.8±6.1 min) (P<0.05).

• At the 6-month follow-up, there was no difference with the two-point discrimination (2PD) of the palmar part of the flaps and the Total Active Movement (TAM) of injured figures in Group A and Group B.

• The MHQ summary scores in Group A (94.29±3.14) were much higher than in Group B (91.73±3.41) (P<0.05).

• Evaluation of the MHQ subscale performance showed that the overall hand function, activities of daily living, work performance and pain score had no differences(P>0.05), but aesthetics (92.15±7.16) and satisfaction (92.45±5.61) score in Group A was higher than aesthetics (86.56±5.60) and satisfaction (86.72±8.21) score in Group B (P< 0.05 for both).

The authors concluded that - The reconstruction using parallelogram flaps is a easier and more versatile treatment with better functions, less morbidity and better aesthetics. This method is a better choice for reconstruction of fingertip injury.

Further reading:

Parallelogram flap versus homodigital island flap in the treatment of fingertip defects with bone exposure: a prospective controlled study

Zhang et al.

Journal of Orthopaedic Surgery and Research (2022) 17:326

https://doi.org/10.1186/s13018-022-03214-1