Advantages and disadvantages of bipedicle kite flap for covering soft tissue defects of the thumb.

Abstract

To evaluate the outcomes of the bipedicle kite flap for coverage of thumb soft tissue defects and to analyze the advantages and disadvantages of the flap. This was a retrospective study without a control group. Seventeen soft tissue defects of the thumb in 17 patients were reconstructed using the bipedicle kite flap from May 2016 to October 2024. Complete flap survival was achieved in all cases, while venous congestion occurred in 1 of 17 cases. Regarding functional outcomes, the mean Kapandji score was 8.6, and no cases of first web-space contracture were observed. Sensory recovery was observed in all flaps, with a mean static two-point discrimination of 12.2 mm. Fifteen of 17 cases achieved complete cortical reorientation. At the donor site, 4 of 17 cases (23.5%) demonstrated limitation of proximal interphalangeal joint flexion, with a mean decrease in range of motion of 16.3 degrees compared with the contralateral side. The flap appears to be a reliable option for coverage of thumb soft tissue defects, with complete flap survival and no significant limitation in pedicle length. However, decreased range of motion of the proximal interphalangeal joint of the donor finger was observed in 23.5% of cases. Level IV.