Clinical study in emergency coverage of thumb pulp defect by three procedures

Objective To report the treatment outcome of emergency coverage of thumb pulp defect by transfer of three kinds of flaps.Methods Twenty one cases with thumb pulp defects were repaired by transfer of 3 different flaps: pedicled dorsal island flap of index finger, the reverse island flap with a pedicle of the thumb radial artery, and free transplantation of toe pulp flap. Results All of the flaps survived except partial necrosis in 1 case. Over a period of 6 24 months follow up (average 10 months), the blood supply, elasticity and texture of flap were satisfactory. An average of the two point discrimination was 9 .2mm in pedicled dorsal island flap of index finger, 8 mm in the reverse island flap with a pedicle of the radial artery of thumb, and 5.6 mm in free transplantation of toe pulp flap.Conclusions Free transplantation of the toe pulp flap was of choice in emergency repair of thumb pulp defect if possible, and pedicled dorsal island flap of index finger, the reverse island flap with a pedicle of the radial artery of thumb can also be alternatively applied.