Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Effect of Two Surgery Methods of Finger Repair (Palmar Graft and V-Y Plasty) on the Improvement of Two-Point Discrimination

Document Type : Original Article (s)

Authors
Mohammad Dehghani 1
Amir Hossein Akbarpoor 2
Mohammad Ali Koofei 2
Shaghayegh Dehghani 2
1 Associate Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Fingertip injury is the one of the most common hand injuries that its healing is important because of the essential role of fingertips in sensory and motor function. The most important part of sensory healing is to obtain two-point discrimination. The common surgical methods of fingertip repair are V-Y plasty and palmar graft. But, there is not enough study on  comparing the efficacy of two methods. The aim of this study was to compare the rate of sensory improvement in these two surgical methods.Methods: In a cohort study, 70 patients with fingertip injury who were operated via V-Y plasty method compared with 70 patients operated via palmar graft method. Two-point discrimination was applied scale for evaluation of improvement at the end of 3 and 6 months after taking the surgery. The comparison between the two groups was done using SPSS software.Findings: 3 months after the surgery, tow-point discrimination was less than 5 in 2 patients of V-Y pasty (6.7%) and in 10 patients of palmar graft (14.7%); according to Fisher’s exact test, no statistically difference between the two groups were seen (P = 0.28). 6 months after the surgery, the improvement of two-point discrimination in V-Y plasty [22 patients (36.7%)] was statistically better than palmar graft [12 patients (17.6%)] (P = 0.04).Conclusion: Applying of V-Y plasty in the treatment of fingertip injury, at least in two-point discrimination, is better than the palmar graft method. In addition, the duration time of surgery, hospital cost and post-operative complication in the V-Y plasty method is less than the palmar graft.Keywords: Fingertip injury, Two-point discrimination, V-Y plasty, Palmar graft 
Keywords
Fingertip injury
Two-point discrimination
V-Y plasty
Palmar graft
  1. Browm EZ, Pederson WC. Skin grafts and skin flaps. In: Green DP, Editor. Green's operative hand surgery. 5th ed. London, UK: Elsevier/Churchill Livingstone; 2005. p. 1629-714.
  2. Wright PE. Acute hand injuries. In: Campbell WC, Canale T, Beaty JH, Editors. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, PA: Mosby/Elsevier, 2008. p. 3821-50.
  3. Khouri RK, Bodia A. Reconstructive surgery. In: Mathes SJ, Hentz VR, Editors. Plastic Surgery. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2006. p. 207-52.
  4. Shepard GH. The use of lateral V-Y advancement flaps for fingertip reconstruction. J Hand Surg Am 1983; 8(3): 254-9.
  5. Adani R, Busa R, Castagnetti C, Bathia A, Caroli A. Homodigital neurovascular island flaps with "direct flow" vascularization. Ann Plast Surg 1997; 38(1): 36-40.
  6. Lee DH, Mignemi ME, Crosby SN. Fingertip injuries: an update on management. J Am Acad Orthop Surg 2013; 21(12): 756-66.
  7. Antevy P, Saladino R. Management of finger injuries. In: King C, Henretig FM, Editors. Textbook of pediatric emergency procedures. Philadelphia, PA: Lippincott Williams & Wilkins; 2008. p. 939.
  8. Tupper J, Miller G. Sensitivity following volar V-Y plasty for fingertip amputations. J Hand Surg Br 1985; 10(2): 183-4.
  9. Moberg Flap (Palmar advancement flap) [Online]. [cited 2013 Jan]; Available from: URL: http://www.wheelessonline.com/ortho/moberg_flap_palmar_advancement_flap
  10. Motamed S, Beikpour H. Survey Volar VY Advancement Flap sense to seek healing fingertips. Pejouhandeh 2004; 9(6): 361-3. [In Persian].
  11. Thoma A, Vartija LK. Making the V-Y advancement flap safer in fingertip amputations. Can J Plast Surg 2010; 18(4): e47-e49.
  12. Yavari M, Motamed S, Ziaie A. Comparison of fingertip sensibility following neurovascular Island Flap and V-Y Flap for fingertip reconstruction. Pajouhesh Dar Pezeshki 2010; 34(2): 86-91. [In Persian].
  13. v-y plasty [Online]. [cited 2013]; Available from: URL: http://dictionary.reference.com/browse/v-y+ plasty
Journal of Isfahan Medical School
Volume 33, Issue 323 - Serial Number 323
January and February 2015
Pages 152-159

  • Receive Date 23 February 2015
  • Accept Date 06 April 2022