Document Type : Original Article
Authors
1
Plastic surgery department, Faculty of medicine, Minia university, Egypt
2
Professor of Plastic Surgery, Faculty of Medicine, Minia University, Egypt
3
Professor & head of Plastic & reconstructive surgery department , minia university
4
Lecturer at Plastic Surgery Department, Faculty of Medicine, Minia University, Egypt
Abstract
Background
The thumb is essential for hand function,.Thumb tip defects tin trauma requires precise repair to restore function and appearance.Thumb defect involves challenges that require immediate coverage to preserve function,sensation,and aesthetics,often using various flap techniques.Common options include the Moberg flap,FDMCA flap, cross-finger flap,and Littler's neurovascular flap,each with specific benefits and limitations.The Brunelli flap,a single-stage fasciocutaneous flap,offers a confined donor site,inconspicuous scars,and versatility for small-to-moderate defects.This case study explores the outcomes of using the thumb dorsoulnar artery pedicle flap for thumb tip reconstruction.
Aim of the work
The aim of this study is to evaluate the range of motion of the thumb,donor site morbidity,and aesthetic outcomes of the Brunelli flap in the reconstruction of thumb tip injuries at the Plastic and Reconstructive Surgery Department in Minia University Hospital.
Patients and Methods
This prospective clinical study was conducted in the Plastic Surgery Department, Minia University Hospital. It included 10 patients with thumb tip defects.
Results
The study on the Brunelli flap for thumb tip reconstruction involved 10 patients, with crush trauma as the most common injury. All flaps survived, with minimal complications. Sensory recovery showed two-point discrimination of 8–10 mm, and 90% of aesthetic outcomes were rated good or excellent. The Brunelli flap offered favorable donor site healing and high patient satisfaction.
Conclusion
The Brunelli flap is a reliable technique for thumb tip reconstruction,providing excellent flap survival, favorable functional and aesthetic outcomes, minimal donor site morbidity, and a quick recovery. With rare and manageable complications, offering good balance of function and appearance.
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