Background: Soft tissue reconstruction of thumb defects
is of paramount importance to keep the safety of deeper
structures and preserve the function of thumb. Proper selection
of flap coverage must provide a versatile, pliable coverage
with restored thumb motor function and sensibility in pulp
area, in one stage procedure with acceptable aesthetic outcome
in both donor and defect areas. The aim of this study was to
compare the use of two regional flaps 1st dorsal metacarpal
artery flap versus the reverse homodigital dorsoradial artery
flap in reconstruction of partial soft tissue defects in the thumb
as regard the function, sensibility and aesthetic outcome.
Patients and Methods: Eighteen patients had been included
in this prospective study was divided randomly in two groups
A and B, they undergone the procedures. In the two groups;
the flap dimensions, and operative time were recorded intraoperatively.
Postoperatively; the motor function, two point
discrimination testing for sensibility, the complications, and
the aesthetic outcome were assessed during the follow-up
period.
Results: All flaps in both groups were survived, venous
congestion was the main complications, which was more
occurring in group B (3 cases) than group A (one case). There
was statistically significant difference regarding the flap
dimensions and operative time between the two groups.
Restored motor function and sensibility were satisfactory in
both groups. Aesthetically; the redial scars were more appealing
in group B than A.
Conclusion: Beside the well-known 1st DMCA flap, the
RHDDRA flap could be a useful alternative in thumb reconstruction
with less operative time, larger skin island dimensions
and more attractive residual scars.