Finger palmar surface reconstruction using medial plantar venous flap: possibility of sensory restoration without neurorrhaphy.

Abstract

Because plantar anatomic features are similar to those of the palmar surface of the finger, palmar surface finger reconstruction using a medial plantar venous flap enables grasping without slippage, results in strength that can withstand friction, and provides a cushioning effect. Furthermore, sensory restoration is thought to be excellent due to the similarity of the tissues. We performed finger palmar surface reconstruction in 6 patients using venous flap without harvesting the medial plantar subcutaneous nerve branch and assessed the sensory restoration using a static 2-point discrimination test (s-2PD), moving 2-point discrimination test (m-2PD), and Semmes-Weinstein test (S-W test). The mean s-2PD at 12 months after surgery was 8.6 mm, the mean m-2PD was 6.00 mm, and the S-W test score was 3.84-3.22 These findings indicate that sensory improvement can be obtained by finger palmar surface reconstruction without grafting of the medial plantar subcutaneous nerve branch to the digital nerve.