A Modified Free Thenar Flap with Constant Innervations and Its Clinical Application

Han, Seung Kyu; Yang, Jae Won; Kim, Jin Soo; Lee, Dong Chul; Ki, Sae Hwi; Roh, Si Young

Abstract

PURPOSE
A modified free thenar flap was designed for coverage of volar finger defect with constant innervation using the palmar cutaneous branch of the median nerve. After clinical application of this flap, sensory results were evaluated in 6 cases.
METHODS
Patients were selected who have volar soft tissue defect with or without fingertip defect. The six cases of the innervated free thenar flap were performed since September 2009, and sensory outcomes were evaluated by the Semmes-Weinstein monofilament and two-point discriminator at four and half month after the surgery.
RESULTS
The Semmes-Weinstein Monofilament test revealed 3 cases showed 2.83, 1 case showed 3.61, 1 case showed 4.31 and 1 case showed 4.56. The static two-point discrimination test revealed 1 case showed 4mm, 1 case showed 6mm, 2 cases showed 9mm, and 2 cases showed over 15mm. The moving two-point discrimination test revealed 1 case showed 3mm, 1 case showed 4mm, 1 case showed 5mm, 1 case showed 7mm, and 2 cases showed over 15mm. The donor sites showed no significant limitation of the thumb and neuroma formation.
CONCLUSION
The innervated free thenar flap showed good sensory outcomes as a sensate free flap in a short time after surgery. It can be an option for coverage of volar finger defects that requires sensation.