In degloving injury of the thumb the large skin defect needs cover with sensate, glabrous and pliable skin. Although coverage of this defect with a sensate free flap from the foot is the best choice, most commonly, cover is achieved using a non-sensate distant pedicle flap. Between 2001 and 2003, degloving injuries of the thumb in eight patients were reconstructed using a sensate radial forearm flap in the sensory territory of the lateral ante-brachial nerve of the forearm which was repaired to the digital nerve of the thumb (six cases) or to a branch of the sensory radial nerve (two cases). Follow-up period ranged from 17 to 41 months (mean: 29.9 months). Sensory evaluation was performed using the moving two point discrimination (M-2PD) and static two point discrimination (S-2PD) of the volar forearm skin. These altered significantly after transfer and their values approached those of the contra-lateral thumb but never reached normal sensation (p<0.01). Sensate radial forearm island flap is a reliable option to cover a large defect of the thumb such as degloving injury and the sensation produced is acceptable.
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Published online: July 26, 2006
Accepted: May 9, 2006
Received: November 24, 2005
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.