Donor finger had no significant effect on range of motion in cross-finger flap surgery in fingertip injuries

New research revealed that no significant difference was found in the range of motion of the donor's finger with the contralateral finger in cross-finger flap in fingertip injuries. The study was published in the Indian Journal of Plastic Surgery. 

Fingertip injuries that are complicated by pulp loss, bone or tendon exposure will generally need a flap cover. Cross finger flap is commonly used to cover such defects. Cross-finger flap surgeries restore the sensation and metabolic activity of pain-free finger function. But not much has been discussed about the morbidity of the donor's finger in a cross-finger flap as much the outcomes of the flap were discussed. Literature reported conflicting results on the sensory, functional, and aesthetic morbidity of donor fingers. Hence researchers conducted a study to assess the objective parameters for sensory recovery, stiffness, cold intolerance, cosmetic outcome, and various other outcomes in donor's fingers. 

Following the PRISMA guidelines, a literature search was carried out using cross-finger, heterodigital, donor-finger, and trans-digital words relevant articles were retrieved. Data regarding the demography, donor-finger outcomes like the 2-point discrimination, range of motion, cold intolerance, follow-up durations, and other questionnaires were collected from the studies and analyzed. MetaXL was used to carry out a meta-analysis and the Cochrane risk of bias tool was used to evaluate the risk of bias. 

Results: 

• Nearly 16 studies were included, out of which 279 patients were objectively evaluated for donor finger morbidity. 
• The middle finger was most frequently used as a donor. 
• When compared to the contralateral finger, static two-point discrimination seemed to be impaired in the donor finger. 
• No significant difference was observed in the range of motion of interphalangeal joints in donor and control fingers when a meta-analysis of the ROM was carried out.  
• Cold intolerance was observed in one-third of the donor's fingers. 

Thus, range of motion has no significant difference in cross-finger flap surgeries in finger-tip injuries. 

Further reading: Donor Finger Morbidity in Cross-Finger Flap: A Systematic Review and Meta-Analysis. Indian J Plast Surg 2023; 56(03): 201-207. 10.1055/s-0042-1760092