Neurovascular cutaneous island pedicles for deficient median nerve sensibility. New technique and results of serial functional tests

The surgical technique is presented for the transfer of a neurovascular cutaneous island pedicle from the adjacent surfaces of the ring and little finger including the intervening web, to the thumb and index finger for irreparable median-nerve loss. The early results are presented after six of these operations, after transfer of a radial-innervated cutaneous island from the index finger, and after eight ring-finger, neurovascular, cutaneous island pedicles. The results of postoperative testing of the neurovascular, cutaneous, island pedicles demonstrated a progressive loss of sensibility until only protective sensation remained. This study indicated that the radial aspect of the hand is used for gross activity following irreparable median nerve injury, and that this functional change is not influenced by a neurovascular cutaneous island pedicle. The operation is indicated only in the patient who must have protective sensibility in the web between the thumb and index finger for his occupation.