Comparison of Outcomes of V-Y Atasoy vs Pentagonal Advancement Flap in the Management of Fingertip Injuries Allen Type II and III in a Tertiary Hospital
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Abstract
Background. Fingertip injuries are the most common traumatic conditions of the hand, affecting productivity and livelihood due to a decrease in manual labor capabilities. The V-Y Atasoy advancement flap is typically effective in managing dorsal or transverse fingertip Allen type II and III injuries but may result in complications like dog ears, flap necrosis, paresthesia, and hook nail deformities.
Objective. This paper aimed to describe the assessment, operative technique, and outcomes in patients with fingertip injury Allen type II and type III treated with the V-Y Atasoy advancement flap versus the pentagonal flap. We also aimed to compare the outcomes and complications associated with each technique.
Methodology. A randomized controlled trial was done among patients with fingertip injury Allen type II and III who were admitted to a tertiary hospital.
Results. There were no significant differences in the rates of immediate complications (flap necrosis, infection, dog ear deformity) or short-term outcomes (two-point discrimination, Semmes-Weinstein monofilament test) between the two groups. Most patients had excellent satisfaction and were able to return to work.
Conclusion. Patients of the two groups had good to excellent outcomes and had minimal complications, with no significant differences between the groups. The pentagonal flap can be an alternative to the V-Y Atasoy flap in managing fingertip injuries, especially those with a larger surface area of injury.
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References
1. Chang J, Vernadakis AJ, McClellan WT. Fingertip injuries. Clin Occup Environ Med. 2006;5(2):413-22, ix. https://pubmed.ncbi.nlm.nih.gov/16647658 https://doi.org/10.1016/j.coem.2005.11.010
2. Martin C, Gonzalez del Pino J. Controversies in the treatment of fingertip amputations. Conservative versus surgical reconstruction. Clin Orthop Relat Res. 1998(353):63-73. https://pubmed.ncbi.nlm.nih.gov/9728160 https://doi.org/10.1097/00003086-199808000-00008
3. Sungur N, Kankaya Y, Yildiz K, et al. Bilateral V-Y rotation advancement flap for fingertip amputations. Hand (N Y). 2012;7(1):79-85. https://pubmed.ncbi.nlm.nih.gov/23448959 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3280365 https://doi.org/10.1007/s11552-011-9389-6
4. Hwang E, Park BH, Song SY, et al. Fingertip reconstruction with simultaneous flaps and nail bed grafts following amputation. J Hand Surg Am. 2013;38(7):1307-14. https://pubmed.ncbi.nlm.nih.gov/23707593 https://doi.org/10.1016/j.jhsa.2013.03.032
5. Pencle FJ, Waseem M. Fingertip Injuries. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.
6. Spyropoulou GA, Shih HS, Jeng SF. Free pulp transfer for fingertip reconstruction-the algorithm for complicated Allen fingertip defect. Plast Reconstr Surg Glob Open. 2015;3(12):e584. https://pubmed.ncbi.nlm.nih.gov/26894009 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727693 https://doi.org/10.1097/GOX.0000000000000569
7. Malshikare VA. Graft reposition on flap: mid-term result in Allen type IV amputation. J Hand Surg Asian Pac Vol. 2019;24(2):219-23. https://pubmed.ncbi.nlm.nih.gov/31035869 https://doi.org/10.1142/S2424835519500292
8. Jung MS, Lim YK, Hong YT, Kim HN. Treatment of fingertip amputation in adults by palmar pocketing of the amputated part. Arch Plast Surg. 2012;39(4):404-10. https://pubmed.ncbi.nlm.nih.gov/22872846 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408288 https://doi.org/10.5999/aps.2012.39.4.404
9. Martin-Playa P, Foo A. Approach to fingertip injuries. Clin Plast Surg. 2019;46(3):275-83. https://pubmed.ncbi.nlm.nih.gov/31103072 https://doi.org/10.1016/j.cps.2019.02.001
10. Gharb BB, Rampazzo A, Armijo BS, et al. Tranquilli-Leali or Atasoy flap: an anatomical cadaveric study. J Plast Reconstr Aesthet Surg. 2010;63(4):681-5. https://pubmed.ncbi.nlm.nih.gov/19285932 https://doi.org/10.1016/j.bjps.2008.12.028
11. Viciana EJ, Lessard AS. Expanded utilization of the digital Atasoy flap. Plast Reconstr Surg Glob Open. 2018;6(12):e2049. https://pubmed.ncbi.nlm.nih.gov/30656123 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326594 https://doi.org/10.1097/GOX.0000000000002049
12. Ozyigit MT, Turkaslan T, Ozsoy Z. Dorsal V-Y advancement flap for amputations of the fingertips. Scand J Plast Reconstr Surg Hand Surg. 2007;41(6):315-9. https://pubmed.ncbi.nlm.nih.gov/17952813 https://doi.org/10.1080/02844310701463357
13. Thoma A, Vartija LK. Making the V-Y advancement flap safer in fingertip amputations. Can J Plast Surg. 2010;18(4):e47-9. https://pubmed.ncbi.nlm.nih.gov/22131847 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300611