Comparison of reverse dorsal radial island flap and reverse thenar island flap for thumb distal defect reconstruction.

Abstract

To compare the efficacy of the reverse dorsal radial island flap and reverse thenar island flap combined with analgesic control in distal thumb defect repair. A retrospective analysis was conducted on 109 patients with distal thumb defects who underwent repair surgery in our department from October 2018 to November 2023. Among them, 55 patients were treated with the reverse dorsal radial island flap and 54 patients received the reverse thenar island flap. The two groups were compared in terms of operative time, static two-point discrimination, total active motion (TAM) of the thumb, total hospital stay, time to return to previous work, numerical rating scale (NRS) pain score, and hand function satisfaction. The mean follow-up periods were 14.1±2.2 months in the reverse thenar island flap group and 13.2±1.2 months in the reverse dorsal radial island flap group. The reverse thenar island flap group showed significantly shorter operative time, no statistically significant differences were observed in static two-point discrimination, TAM, total hospital stay, NRS pain score, time to return to previous work, and hand function satisfaction between the two groups. Both flaps combined with analgesic control are safe and effective for treating distal thumb defects, the reverse thenar island flap offers a shorter operative time and more concealed donor site.