Volume 10, Issue 3 (7-2021)                   WJPS 2021, 10(3): 8-17 | Back to browse issues page


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Chakraborty S S, Kala P C, Sahu R K, Dixit P K, Katrolia D, Kotu S. Fingertip Amputation Reconstruction with VY Advancement Flap: Literature Review and Comparative Analysis of Atasoy and Kutler Flaps. WJPS. 2021; 10 (3) :8-17
URL: http://wjps.ir/article-1-845-en.html
1. Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Jodhpur, India
Abstract:   (105 Views)
Many different flaps had been described to cover exposed bone in fingertip amputations and injuries. The variants of VY advancement flap, by far the simplest, had proven to render good functional and aesthetic outcome. We aimed to revisit and compare the various VY advancement flaps in fingertip reconstruction.
METHODS:
PubMed [MEDLINE] database was searched for VY advancement flap in fingertip reconstruction. Demographic and outcome data were extracted from relevant studies and comparative analysis was made. Patients with fingertip amputations undergoing reconstruction by either Kutler of Atasoy flaps in our institute, were assessed for sensory recovery, cold intolerance, joint’s range of motion, and aesthetic outcomes and results were analysed.
RESULTS:
Among the 744 articles, 32 citations went full text review and were included, while data of 13 articles were tabulated. Weighted mean of 2PD in Kutler and Atasoy estimated to be 6 and 7.5 mm respectively. Hook nail deformity was in 29% and 35%, pain was present in 71% and 30% patients, in Kutler and Atasoy flaps respectively. Forty fingertips with Allen type II/III were reconstructed. Sensory outcomes of Atasoy flap and Kutler flaps were better than the previous study results. Four patients had cold intolerance. All patients achieved satisfactory aesthetic outcome.
CONCLUSION:
Over time, VY advancement flap have been successfully used for reconstruction of Allen type II-IV fingertip amputations, as suggested by the good sensory, functional and aesthetic outcomes.
Full-Text [PDF 1145 kb]   (161 Downloads)    
Type of Study: Original Article | Subject: Special
Received: 2021/10/1 | Accepted: 2021/07/6 | Published: 2021/10/23

References
1. K Sanjeev. Digital Amputations. In: Green's Operative Hand Surgery. 7th ed. Philadelphia: Elsevier; 2017; pp. 1709-17.
2. Ruijs ACJ, Jaquet JB, Daanen HAM, Hovius SER. Cold intolerance of the hand measured by the ciss questionnaire in a normative study population. J Hand Surg Br 2006;31B(5):533-6. doi: 10.1016/j.jhsb.2006.04.013. [DOI:10.1016/J.JHSB.2006.04.013]
3. Rosas S, Paco M, Lemos C, Pinho T. Comparison between the Visual Analog Scale and the Numerical Rating Scale in the perception of esthetics and pain. Int Orthod 2017;15:543-60. doi: 10.1016/j.ortho.2017.09.027 [DOI:10.1016/j.ortho.2017.09.027]
4. Tranquilli-Leali E. Ricostruzione dell'apice delle falangi ungueali mediante autoplastica volare peduncolata per scorrimento. Infort Traumatol Lav 1935;1:186-93.
5. Kutler W. A new method for finger tip amputation. J American Med Assoc 1947;133(1):29. doi: 10.1001/jama.1947.62880010007007. [DOI:10.1001/jama.1947.62880010007007]
6. Atasoy E, Ioakimidis E, Kasdan ML, Kutz JE, Kleinert HE. Reconstruction of the Amputated Finger Tip with a Triangular Volar Flap- A New Surgical procedure. J Bone Joint Surg Am 1970;52A(5):921-6. [DOI:10.2106/00004623-197052050-00006]
7. Freiberg A, Manktelow R. The Kutler Repair For Fingertip Amputations. Plast Reconstr Surg 1972;50(4):371-5. doi: 10.1097/00006534-197210000-00011. [DOI:10.1097/00006534-197210000-00011]
8. Gellis M, Pool R. Two-Point Discrimination Distances In The Normal Hand And Forearm. Plast Reconstr Surg 1977;59(1):57-63. doi: 10.1097/00006534-197701000-00010. [DOI:10.1097/00006534-197701000-00010]
9. Weston PA, Wallace WA. The use of locally based triangular skin flaps for the repair of finger tip injuries. Hand 1976;8(1):54-8. doi: 10.1016/0072-968x(76)90061-9. [DOI:10.1016/0072-968X(76)90061-9]
10. Tupper J. Miller G. Sensitivity Following Volar V-Y Plasty for Fingertip Amputations. J Hand Surg Am 1985;10B(2):183-4. doi: 10.1016/0266-7681(85)90011-7. [DOI:10.1016/0266-7681(85)90011-7]
11. Frandsen PA. V-Y Plasty As Treatment Of Fingertip Amputations. Acta Orthop Scand 1978;49:255-9. doi: 10.3109/17453677809005761. [DOI:10.3109/17453677809005761]
12. Biddulph SL. The neurovascular flap in finger tip injuries. Hand 1979;2(1):59-63. doi: 10.1016/s0072-968x(79)80011-x. [DOI:10.1016/S0072-968X(79)80011-X]
13. Krishnan KG. Sensory recovery after reconstruction of defects of long fingertips using the pedicled V flap. Br J Plast Surg 2001;54:523-7. doi: 10.1054/bjps.2001.3647. [DOI:10.1054/bjps.2001.3647]
14. Shepard GH. The use of lateral V-Y advancement flaps for fingertip reconstruction. J Hand Surg Am 1983;8(3):254-9. doi: 10.1016/s0363-5023(83)80153-1. [DOI:10.1016/S0363-5023(83)80153-1]
15. Saito H, Suzuki Y, Fujino K, Tajima T. Free nail bed graft for treatment of nail bed injuries of the hand. J Hand Surg Am 1983;8(2):171-8. doi: 10.1016/s0363-5023(83)80010-0. [DOI:10.1016/S0363-5023(83)80010-0]
16. Brown RE, Zook EG, Russell RC. Fingertip reconstruction with flaps and nail bed grafts. J Hand Surg Am 1999;24(2):345-1. doi: 10.1053/jhsu.1999.0345. [DOI:10.1053/jhsu.1999.0345]
17. Sabapathy SR, Venkatramani H, Bharathi R, Jayachandran S. Reconstruction of Finger Tip Amputations with Advancement Flap and Free Nail Bed Graft. J Hand Surg Br 2002;27(2):134-8. doi: 10.1054/jhsb.2001.0695. [DOI:10.1054/JHSB.2001.0695]
18. Furlow LT. V-Y "Cup" Flap for Volar Oblique Amputation of Fingers. J Hand Surg Br 1984;9(3):253-6. doi: 10.1016/0266-7681(84)90036-6. [DOI:10.1016/0266-7681(84)90036-6]
19. Venkataswami R, Subramanian N. Oblique Triangular Flap: A New Method of Repair for Oblique Amputations of the Fingertip and Thumb. Plast Reconstr Surg 1980;66:296-300. [DOI:10.1097/00006534-198008000-00026]
20. Bang HH, Kojima T, Hayashi H. Palmar advancement flap with V-Y closure for thumb tip injuries. J Hand Surg Am 1992;17A:933-4. doi: 10.1016/0363-5023(92)90473-3. [DOI:10.1016/0363-5023(92)90473-3]
21. Elliot D, Wilson Y. V-Y Advancement of the Entire Volar Soft Tissue of the Thumb in Distal Reconstruction. J Hand Surg. 1993;18B:399-402. doi: 10.1016/0266-7681(93)90073-o. [DOI:10.1016/0266-7681(93)90073-O]
22. Kumar VP, Satku K. Treatment and prevention of "hook nail" deformity with anatomic correlation. J Hand Surg Am 1993;18(4):617-20. doi: 10.1016/0363-5023(93)90303-K. [DOI:10.1016/0363-5023(93)90303-K]
23. 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. doi: 10.1080/02844310701463357. [DOI:10.1080/02844310701463357]
24. Bharathi RR, Jose Jerome JT, Kalson NS, Sabapathy SR. V-Y Advancement Flap Coverage of Toe-Tip Injuries. J Foot Ankle Surg 2009;48(3):368-71. doi: 10.1053/j.jfas.2009.01.010. [DOI:10.1053/j.jfas.2009.01.010]
25. Sungur N, Kankaya Y, Yildiz K, Dolen UC, Kocer U. Bilateral V-Y rotation advancement flap for fingertip amputations. Hand (N Y) 2012;7(1):79-85. doi: 10.1007/s11552-011-9389-6. [DOI:10.1007/s11552-011-9389-6]
26. Lee SM, Rahman MF, Thirkannad S. Combination V-Y Advancement Flap And Composite Graft For Reconstruction Of An Amputated Fingertip. Hand Surg 2012;17(1):145-9. doi: 10.1142/S0218810412970015. [DOI:10.1142/S0218810412970015]
27. Foo TL, Wan KHM, Chew WYC. Safe and Easy Method to Preserve Fingertip Contour in VY-Plasty. Tech Hand Up Extrem Surg 2012;16(2):95-7. doi: 10.1097/BTH.0b013e31824e1fa2. [DOI:10.1097/BTH.0b013e31824e1fa2]
28. Foo TL, Arul M. Osteocutaneous VY Flap To Preserve Length In Coronal Oblique Fingertip Amputation. Hand Surg 2013;18(2):297-9. doi: 10.1142/S0218810413970046. [DOI:10.1142/S0218810413970046]
29. Chung SR, Foo TL. Crescent Flap For Fingertip Reconstruction. Hand Surg 2014;19(3):459-61. doi: 10.1142/S021881041472037X. [DOI:10.1142/S021881041472037X]
30. Zhou X, Wang L, Mi J, Xu Y, Rui Y, Xue M, Shen X, Qiang L. Thumb fingertip reconstruction with palmar V-Y flaps combined with bone and nail bed grafts following amputation. Arch Orthop Trauma Surg 2015;135:589-94. doi: 10.1007/s00402-015-2163-4. [DOI:10.1007/s00402-015-2163-4]
31. Díaz LC, Vergara-Amador E, Fuentes Losada LM. Double V-Y Flap to Cover the Fingertip Injury. Tech Hand Up Extrem Surg 2016;20(4):133-6. doi: 10.1097/BTH.0000000000000132 [DOI:10.1097/BTH.0000000000000132]
32. Arpaci E, Unlu RE, Altun S, Ertas NM. Super Kutler flap: an alternative technique for reconstruction of fingertip defects. J Hand Surg Eur Vol 2017;42(6):626-32. doi: 10.1177/1753193416686884. [DOI:10.1177/1753193416686884]
33. Viciana EJ, Lessard AS. Expanded Utilization of the Digital Atasoy Flap. Plast Reconstr Surg Glob Open. 2018;6(12):e2049. doi: 10.1097/GOX.0000000000002049 [DOI:10.1097/GOX.0000000000002049]
34. Haehnel O, Plancq MC, Deroussen F, Salon A, Gouron R, Klein C. Long-Term Outcomes of Atasoy Flap in Children With Distal Finger Trauma. J Hand Surg Am. 2019;44(12):1097.e1-1097.e6. doi: 10.1016/j.jhsa.2019.02.018. [DOI:10.1016/j.jhsa.2019.02.018]
35. Appukuttan A, Ragoowansi R. The unilateral perforator V-Y flap for fingertip reconstruction- a versatile technique. JPRAS Open 2019;23:1-7. doi: 10.1016/j.jpra.2019.10.004. [DOI:10.1016/j.jpra.2019.10.004]

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