Early outcome of distally based C-ring cross finger flap for the reconstruction of degloved amputation stumps and volar and dorsal defects of the fingers
DOI:
https://doi.org/10.18203/2349-2902.isj20261991Keywords:
C-ring cross finger flap, Degloved amputation, Finger defect, Hand reconstructionAbstract
Background: Degloved amputation stumps and volar or dorsal finger defects are challenging to reconstruct. The distally based C-ring cross finger flap offers larger size and wider rotation than conventional flaps, but prospective outcome data are limited.
Methods: This prospective observational study included 40 patients undergoing reconstruction of degloved amputation stumps or volar/dorsal finger defects using the distally based C-ring cross finger flap at Dhaka Medical College Hospital (December 2022-January 2024). Outcomes assessed included flap dimensions, viability (necrosis: marginal <10%, partial 10-20%, significant>20%, complete), flap-related complications (venous congestion, infection, wound dehiscence), donor site morbidity (infection, re-skin grafting) and range of motion (ROM) of proximal (PIP) and distal (DIP) interphalangeal joints. Overall functional outcome was classified as good, satisfactory or poor.
Results: Mean flap area was 6.46 cm² (wound area 5.11 cm²). No necrosis occurred in 57.5%; marginal necrosis in 22.5%, partial in 10%, significant in 7.5%, complete loss in 2.5%. Venous congestion occurred in 25%, infection in 10%, wound dehiscence in 10%; 55% had no complications. Donor site morbidity was absent in 65%; infection and re-skin grafting each occurred in 17.5%. Full ROM was achieved in 100% of PIP joints and 97.5% of DIP joints. Overall outcome was good in 70%, satisfactory in 22.5%, and poor in 7.5%.
Conclusions: The distally based C-ring cross finger flap is a reliable technique for reconstructing degloved amputation stumps and finger defects, providing adequate coverage, acceptable flap survival, manageable complications, low donor site morbidity and excellent joint mobility with 70% achieving good functional outcomes.
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