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Rui-xing Hou - One of the best experts on this subject based on the ideXlab platform.

  • Replantation of thumb or fingers with skin Degloving Injury in 30 patients: an outcomes evaluation
    Chinese Journal of Hand Surgery, 2016
    Co-Authors: Rui-xing Hou, Guangzhe Jin
    Abstract:

    Objective To report the clinical outcomes of replantation of thumb and fingers with skin Degloving injuries. Methods Thirty patients with 42 avulsed thumb and fingers treated with replantation from 2007 to 2012 were follow-up for 2 to 7 years (average, 4 years). Based on the level of the Degloving Injury, avulsion of the index, middle, ring and little fingers was categorized into grade Ⅰ avulsion and grade Ⅱ avulsion. The results of replantation were assessed by the provisional functional assessment criteria for thumb and finger replantation issued by the Hand Surgery Society of Chinese Medical Association and by the Michigan hand outcomes questionnaire (MHQ). Results According to the provisional functional assessment criteria for thumb and finger replantation issued by the Hand Surgery Society of Chinese Medical Association, 93.3% of the cases achieved excellent and good results. This satisfactory rate was 100% in grade Ⅰ avulsions and 87.5% in grade Ⅱ avulsions. MHQ revealed high patient satisfaction. Conclusion Replantation of thumb and fingers with skin Degloving injuries can lead to fairly high patient satisfaction with restoration of form and function. Grade Ⅰ avulsions have better results than grade Ⅱ avulsions. Key words: Finger injuries; Replantation; Degloving Injury; Follow-up studies

  • Microsurgery in 46 cases with total hand Degloving Injury
    Elsevier, 2015
    Co-Authors: Rui-xing Hou
    Abstract:

    Objective: To summarize the characteristics of total hand Degloving Injury and investigate the curative effect of microsurgery. Methods: A total of 46 patients with total hand Degloving Injury were enrolled in this study. The Injury classification and treatment methods were as follows: Type I (11 cases), treated by replantation of the gloved skin; Type II (6 cases), treated by reconstruction using thumb wrap-around flap and second toe; Type III (4 cases), treated by reconstruction using bilateral second toe with dorsal foot flap; Type IV (9 cases), treated by replantation in situ or reconstruction; Type V (16 cases), treated by replantation or abdominal flap reconstruction. Results: Of the patients who received Type I treatment, five completely survived, whereas eight had finger necrosis. In Type II, both the reconstructed fingers and hand flaps survived. For four patients who received Type III treatment, eight reconstructed fingers survived. In Type IV, two patients with reconstructed fingers survived, whereas the six with replantation in situ had necrosis of the partial palmar or hand dorsum skin. In Type V, nine patients with reconstructed fingers survived, and five cases with abdominal skin flap reconstruction and one case with anterolateral femoral flap survived. The restoration of hand appearance and function was the best in patients who received replantation. For reconstruction cases, however, the hand function was recovered to the basic self-care level. In cases with abdominal flap reconstruction, the hand function showed poor recovery. Conclusion: Total hand Degloving Injury can be classified into different types according to the Injury degree. The appropriate microsurgical treatment based on these types can produce better curative effect

  • Replantation surgery with vascular anastomosis for treating whole hand Degloving Injury
    Chinese Journal of Hand Surgery, 2012
    Co-Authors: Sheng Xiong, Rong Zhou, Sheng-fu Wang, Rui-xing Hou
    Abstract:

    Objective To report the surgical techniques and clinical efficacy of replantation surgery with vascular anastomosis for treating whole hand Degloving Injury. Methods Nineteen cases of whole hand Degloving Injury were treated with replantation combined with vascular anastomosis.The degloved skin was attached back and the skin of the palm and back of the hand was given light compression bandage. Results Complete survival of the replanted degloved skin was seen in 5 cases.Two cases experienced complete necrosis in 1 to 5 fingers and the skin of the palm and back of the hand.Amputation of five digits from the proximal phalangeal level and abdominal flap for coverage of the palm and dorsum of the hand were done.In 6 cases,partial necrosis in the fingers occurred and these fingers were amputated.In another 6 cases,partial skin necrosis occurred in the palm or the back of the hand and another repair surgery with skin flap was carried out.After 6 to 84 months' follow-up,for 5 cases with complete survival,the hand function such as flexion and extension was satisfactory.For two cases with complete necrosis,the hand function was completely lost.For the other cases,the function of the hand was partially recovered.Sensory recovery in the fingers ranged S2 to S4 and sensory recovery from S1 to S3 was achieved in the skin of the palm and back of the hand. Conclusion Satisfactory therapeutic effect can be obtained when using replantation strgery with vascular anastomosis for treating whole hand Degloving Injury as long as the surgical indications were appropriate. Key words: Hand injuries;  Microsurgery;  Degloving injuries;  Replantation

  • Classification and treatment of whole hand Degloving Injury
    Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery, 2012
    Co-Authors: Haiwen Wang, Rui-xing Hou
    Abstract:

    Objective To summarize the Injury characteristics of the whole hand Degloving Injury and to explore its classification and treatment.Methods Between December 1999 and May 2010,41 cases of the whole hand Degloving Injury were admitted for treatment.There were 28 males and 13 females with an average age of 35 years(range,18-58 years).The causes of Injury included mangled Injury in 28 cases and crush Injury in 13 cases.The interval between Injury and surgery was 1-10 hours(mean,3 hours).According to self-made classification standard for whole hand Degloving Injury,11 cases were rated as type I,5 cases as type II,4 cases as type III,8 cases as type IV,and 13 cases as type V.Type I Injury was treated by replantation surgery with vascular anastomosis,type II by reconstruction with thumb flap and the second toe containing dorsal skin flap,type III by reconstruction with the second toe containing dorsal skin flap of both feet,type IV by replantation surgery with vascular anastomosis,and type V by reconstruction with thumb flap containing dorsal skin flap(8 cases) or repairing with abdominal flap(5 cases).The size of the dorsal flap was between 9 cm × 6 cm and 17 cm × 11 cm and the dorsal donor site was covered with free skin grafting.Results After surgery,partial necrosis occurred at fingers in 6 patients with type I Injury,and at fingers and palm skin in 6 patients with type IV Injury;the flaps,the reconstructed fingers,and replanted skin all survived in the others.The grafted skin at donor sites successfully healed.Forty cases were followed up from 6 months to 7 years(mean,14 months).The skin color and texture were close to normal hand in the cases undergoing replantation,who had the best function restoration with S2-S4 sensory recovery;the hand function was basically restored with S2-S3 sensory recovery in the cases undergoing finger reconstruction with thumb and toe flaps;and the restoration of the hand function was not satisfactory with S1-S2 sensory recovery in the cases undergoing abdominal flaps.Conclusion Whole hand Degloving Injury can be classified into different types according to Injury degree and this will help choose the clinical treatment plan.The appropriate treatment based on these types can obtain better clinical effectiveness.

  • repair of whole hand destructive Injury and hand Degloving Injury with transplant of pedis compound free flap
    Chinese Journal of Reparative and Reconstructive Surgery, 2009
    Co-Authors: Qiang Zhao, Haiwen Wang, Guangzhe Jin, Yuefei Liu, Cheng Wei, Xinyi Liu, Rui-xing Hou
    Abstract:

    OBJECTIVE To investigate the surgical method and clinical efficacy of repairing whole-hand destructive Injury or hand Degloving Injury with the transplant of pedis compound free flap. METHODS From February 2003 to June 2008, 21 patients with whole-hand destructive Injury or hand Degloving Injury were treated, including 15 males and 6 females aged 18-45 years old (average 25 years old). The Injury was caused by punching machine crush in 10 cases, roller crush in 7 cases, and imprinter crush in 4 cases. The time between Injury and operation was 1-9 hours. Eleven cases had the skin-Degloving Injury of the whole hand, while the other 10 cases had the proximal palm Injury combined with dorsal or palmar skin and soft tissue defect. After debridement, the size of wound was 9 cm x 7 cm-15 cm x 10 cm in the dorsal aspect and 10 cm x 7 cm-6 cm x 10 cm in the palmar aspect. The defect was repaired by the thumbnail flap of dorsalis pedis flap and the second toenail flap of dorsalis pedis flap in 5 cases, the thumbnail flap of dorsalis pedis flap and the second toe with dorsalis pedis flap in 4 cases, and bilateral second toe with dorsalis pedis flap in 12 cases. The flap area harvested during operation ranged from 6 cm x 5 cm to 16 cm x 11 cm. Three fingers were constructed in 2 cases and two fingers in 19 cases. Distal interphalangeal joint toe amputation was conducted in the thumbnail flap donor site, metatarsophalangeal joint toe amputation was performed in the second toenail flap donor site, and full-thickness skin grafting was conducted in the abdomen. RESULTS At 7 days after operation, the index finger in 1 case repaired by the second toenail flap suffered from necrosis and received amputation, 1 case suffered from partial necrosis of distal dorsalis pedis flap and recovered after dressing change, and the rest 42 tissue flaps survived. Forty-three out of 44 reconstructed fingers survived. All the wounds healed by first intention. At 2 weeks after operation, 2 cases had partial necrosis of the donor site flap and underwent secondary skin grafting after dressing change, the rest skin grafts survived, and all the wounds healed by first intention. Nineteen cases were followed up for 6-36 months (average 11 months). The flaps of palm and dorsum of hand showed no swelling, the reconstructed fingers had a satisfactory appearance and performed such functions as grabbing, grasping, and nipping. The sensory of the flaps and the reconstructed fingers recovered to S2-S4 grade. The donor site on the dorsum of the foot had no obvious scar contracture, without obvious influence on walking. CONCLUSION For the whole-hand destructive Injury or hand Degloving Injury, the method of transplanting pedis compound free flap can repair the defect in the hand and reconstruct the function of the injured hand partially. It is an effective treatment method.

Yang Dianyu - One of the best experts on this subject based on the ideXlab platform.

  • combined implantation of bilateral dorsalis pedis flap with toe web space on treatment of the skin Degloving Injury in the hands
    Chinses Journal of Hand Surgery, 2001
    Co-Authors: Yang Dianyu
    Abstract:

    Objective To introduce a new method of combined implantation for treatment of skin Degloving Injury in the hand.Methods 6 cases of skin Degloving Injury in the hands were repaired by combined implantation of bilateral dorsalis peids flap with toe web space. Reconstruction of thumb , middle and ring finger was done simultaneously. The skin defect of hand at the palm and dorsal sides were repaired by the dorsalis pedis flap,and the first web by toe web space. Results Six cases were obtained successful results .Over 1 to 3 years period of follow up,the appearance of hands was satisfactory, with a comparable size of the first web as the unaffected side. Pinch between thumb and middle and ring finger functioned well. The 2 PD was achieved 6 to 9 mm. Conclusions Free toe implantation with double dorsalis pedis flap with toe web space is a good approach in treatment of the skin Degloving Injury in the hand.

Bin Wang - One of the best experts on this subject based on the ideXlab platform.

  • application of ilizarov technique in functional reconstruction of thumb Degloving Injury after amputation
    Chinese Journal of Reparative and Reconstructive Surgery, 2018
    Co-Authors: Bin Wang, Chao Chen, Hui Wang, Zhao Meng, Wei Liu, Ruizheng Hao, Jian Zhang, Yongxin Huo, Song Jia
    Abstract:

    Objective To investigate the effectiveness of Ilizarov technique in reconstruction of thumb function in patients with thumb Degloving Injury after amputation. Methods Between June 2011 and September 2016, 9 cases of thumb Degloving Injury were treated with amputation and Ilizarov technology. There were 8 males and 1 female with an age of 18-52 years (mean, 34.7 years). The amputation plane was the level of the metacarpophalangeal joint in 5 cases, the level of the proximal metacarpophalangeal joint in 2 cases, and the level of the base of the proximal phalanx in 2 cases (the length of proximal phalanx was less than 1 cm). After amputation, the affected finger was shorter than the healthy finger by 4.0-7.5 cm, with an average of 5.7 cm. On the fifth day after operation, the semi-loop external fixation extender was applied for extension, which was extended by 0.5 mm per day, and was extended once every 6 hours. Results After bone lengthening surgery, the first web space elevation and contracture occurred in 8 cases. Six of them were treated with the amputation of the inner muscle of the thumb and the "Z" forming technique, postoperative thumb function recovered well; the remaining 2 cases rejected plasty. All 9 patients were followed up 14-47 months, with an average of 33 months. Bone lengthening time was 64-122 days, with an average of 86 days. The lengthening length of bone was 3.0-5.9 cm, with an average of 4.1 cm, and the average lengthening length was 71.9% of the average shortened length. The fixation time of external fixator was 169-342 days, with an average of 231 days. The healing index was 43.2-59.1 days/cm, with an average of 53.4 days/cm. One case showed prolonged mineralization delay and recovered after "accordion" treatment. Bone healing was finally achieved in all patients, with the healing time ranging from 169 to 342 days, with an average of 231 days. No replantation internal fixation and flexion contracture occurred. The two-point discrimination of extended fingertip was similar to that of normal fingertip. The grip strength reached 53%-89% of the healthy side; the kneading force reached 59%-91% of the healthy side. Conclusion The application of Ilizarov technology to extend the thumb metacarpal lengthening is a good method to reconstruction the thumb function after Degloving Injury.

  • application of ipsilateral digital proper artery dorsal branch flap to repair mid phalanx Degloving Injury with distal segment finger defect
    Chinese Journal of Reparative and Reconstructive Surgery, 2018
    Co-Authors: Huanyou Yang, Bin Wang, Lei Huang, Wei Wang
    Abstract:

    Objective To investigate the effectiveness of ipsilateral digital proper artery dorsal branch flap to repair mid-phalanx Degloving Injury with distal segment finger defect. Methods Between February 2013 and July 2016, 11 cases (11 fingers) of mid-phalanx Degloving Injury with distal segment finger defect were treated. There were 9 males and 2 females with an average age of 33.6 years (range, 18-59 years). The Injury caused by twisting in 8 cases and crushing in 3 cases. The Injury located at index finger in 3 cases, middle finger in 6 cases, and ring finger in 2 cases. The skin avulsion was from proximal interphalangeal joint in 1 case, proximal 1/4 of mid-phalanx in 6 cases, and 1/2 of mid-phalanx in 4 cases. The area of wounds ranged from 4.0 cm×1.7 cm to 6.2 cm×2.6 cm. The interval between Injury and operation was 2.5-6.0 hours (mean, 4.5 hours). All defects were repaired with the ipsilateral digital proper artery dorsal branch flaps. The size of flaps ranged from 4.4 cm×1.9 cm to 7.0 cm×2.9 cm. Nerve anastomose was carried between digital proper nerve dorsal branch in the flap and digital proper nerve stump in the wound. The donor sites were repaired by skin grafting. Results Tension blisters of the flap and partial necrosis occurred in 1 case, and healed after dressing change. The other flaps and skin grafting survived, and wounds healed by first intention. All patients were followed up 6-18 months (mean, 16 months). The texture and appearance of all the flaps were satisfactory. At 6 months after operation, two-point discrimination of flaps ranged from 7 to 10 mm (mean, 8.5 mm). At last follow-up, according to the functional assessment criteria of upper limbs by the Branch of Hand Surgery of Chinese Medicine Association, the results were excellent in 10 cases and good in 1 case, with the excellent and good rate of 100%. Conclusion The ipsilateral digital proper artery dorsal branch flap is a good method to repair mid-phalanx Degloving Injury with distal segment finger defect for the advantages of simple operation, less damage in donor site, high survival rate of the flap, and good feeling recovery of the finger.

  • clinical observation of combined skin flap and abdominal flap for repair of distal finger Degloving Injury
    Chinese Journal of Microsurgery, 2018
    Co-Authors: Jianfeng Zhang, Wei Wang, Bin Wang, Huanyou Yang, Ruizheng Hao, Yongxin Huo, Wenlong Zhang
    Abstract:

    Objective To compare the clinical effect and operation difficulty of the combined skin flap with reversed proper palmar digital arterial dorsal branch island flap and cross-finger flap and the abdominal flap in the treatment of distal finger Degloving Injury. Methods Inclusion criteria: ①Soft tissue defect far beyond the level of distal interphalangeal joints. ②The inured finger was from second to fifth. ③Single finger Injury. ④ Iniury time within 8 h. Exclusive criteria: ①With tendon Injury.② Multiple finger injuries. ③Followed-up time within 6 months. Between February, 2009 and September, 2016, 52 patients (52 fingers) with distal finger Degloving Injury were reviewed, there were 32 males and 20 females, aged from 18 to 60(36.02±11.00) years. The time from Injury to operation was 2.5-8.0 (4.81±1.28) h. Affected fingers included index finger in 15 cases, middle finger in 22 cases, ring finger in 10 cases, and little finger in 5 cases. Twenty patients (20 fingers) were treated by combined skin flap with reversed digital arterial dorsal branch island flap and cross-finger flap(group combined-flap). The cubital skin was grafted onto the donor sites. Thirty-two patients (32 fingers) were treated by abdominal flap (group abdominal-flap). Results The patients were followed-up 6-25 (9.25±3.97) months. The operation time: group combined-flap was 80-130(98.46±8.34) min and group abdominal-flap was 85-125(107.84±8.63)min. There was no significant difference in two groups(P>0.05). Pedicle division time: group combined-flap was 15-24 (16.75±1.74) d and group abdominal-flap was 24-45(28.31±5.12) d. There was a significant difference in two groups(P<0.05). And the pedicle division time in group combined-flap was much shorter than in group abdominal-flap. Flap function at last follow-up, the excellent and good rate of the flap in group combined-flap and group abdominal-flap was 90.00% and 59.38%, respectively. There was a significant difference in two groups (P<0.05), and the flap function in group combined-flap was much better than in group abdominal-flap. Affected finger function at last follow-up, the excellent and good rate of the affected fingers was 95.00% and 71.88%. There was a significant difference in two groups(P<0.05), and the affected finger function in group combined-flap was much better than in group abdominal-flap. Conclusion The combined skin flap with reversed digital arterial dorsal branch island flap and cross-finger flap is a simple and high-survival-rate flap, whose texture, appearance and clinical outcome for repair of distal finger Degloving Injury are much better than traditional abdominal flap. Key words: Degloved Injury; Finger; Dorsal branch, proper palmar digital artery; Island flap; Cross finger skin flap; Combined skin flap; Repair

  • transfer of double hump flap from the same finger for repair of distal finger Degloving Injury
    Chinese Journal of Hand Surgery, 2017
    Co-Authors: Jianfeng Zhang, Wei Wang, Bin Wang, Huanyou Yang, Xiaoxuan Fei
    Abstract:

    Objective To investigate the surgical procedures and the clinical results of repairing Degloving Injury of the distal finger. Methods Between January 2010 and May 2014, 34 patients (34 fingers) with Degloving Injury of the distal finger were treated. There were 24 males and 10 females with ages ranging from 21 to 60 years (mean, 35 years). The time from Injury to operation was 1 to 8 hours (mean, 4.5 hours). Affected fingers included index finger in 7 cases, middle finger in 15 cases, ring finger in 9 cases, and little finger in 3 cases. Twelve cases were complicated with fracture of the distal phalanx. The defect area ranged from 2.0 cm×1.8 cm to 3.0 cm×2.5 cm. Modified reverse island flap based on the dorsal branch of the digital artery was used to cover the defects of the distal finger caused by the Degloving Injury. The flap shaped like the humps of a camel (double hump flap). Full thickness skin graft from the forearm was used to cover the donor site. Results Blister and scabs occurred in 8 cases, and two of them were revised by second intention. The other flaps and skin grafts survived uneventfully. The patients were follow-up for 6 to 20 months (mean, 9.3 months). All the flaps presented satisfactory appearance and texture, and the flexion and extension function of affected fingers nearly returned to normal. Two-point discrimination ranged from 6.2 to 9.1 mm at the last follow-up. According to the functional assessment criteria of the upper limb formulated by the Hand Surgery Society of the Chinese Medical Association, the results were excellent in 24 cases, good in 8 cases, and fair in 2 cases, the excellent and good rate being 94.1%. Conclusion Modified reverse island flap based on the dorsal branch of the digital artery, namely the double-hump flap, is a simple and safe, easy-to-operate and effective method for treating Degloving Injury of the distal finger. Key words: Finger injuries; Surgical flaps; Degloving Injury; Proper digital artery

  • treatment of fingertip Degloving Injury using the bilaterally innervated sensory cross finger flap
    Annals of Plastic Surgery, 2014
    Co-Authors: Chao Chen, Peifu Tang, Lihai Zhang, Bin Wang
    Abstract:

    Treatment of a fingertip Degloving Injury continues to be a challenge problem. This article reports repair of this type of Injury using a modified cross-finger flap, including both dorsal branches of the digital nerves. From December 2007 to March 2010, the flap was used in 17 digits of 17 patients who had a fingertip Degloving Injury. There were 13 men and 4 women with mean age of 33 years. The injured fingers requiring reconstruction included 5 index, 6 middle, and 6 ring fingers. The mean size of the soft tissue losses was 4.2 × 1.9 cm. The mean flap size was 4.4 × 2.2 cm. Neurorrhaphy was performed between the dorsal branches harvested with the flap and the digital nerves of the injured finger. For comparison, we also collected a series of 28 patients who had a fingertip Degloving Injury treated with a cross-finger flap without nerve repair. In the study group, all flaps survived completely. At a mean follow-up of 23 months, the average score of static 2-point discrimination on the finger pulp was 7.2 mm. According to the visual analog scale, 12 patients had no pain, 4 reported mild pain, and 1 experienced moderate pain. Positive Tinel sign was found in only 1 reconstructed finger. Of the comparison group (mean follow-up, 22 months), the average static 2-point discrimination was 9.8 mm. On the basis of the visual analog scale, no pain, mild pain, and moderate pain were noted in 18, 7, and 3, fingers, respectively. Positive Tinel sign was found in 9 reconstructed fingers. The outcomes of the 2 groups were significantly different. The bilaterally innervated sensory cross-finger flap is an effective method for repairing the fingertip Degloving Injury. The authors suggest that double nerve repairs should be performed to improve the pulp sensation and reduce the incidence of the painful neuroma.

Yong Shen - One of the best experts on this subject based on the ideXlab platform.

  • revision surgery with dermal regeneration template and vacuum sealing drainage for reconstruction of complex wounds following necrosis of reattached avulsed skins in a Degloving Injury a case report
    Medicine, 2019
    Co-Authors: Qiusheng Wang, Rui Jia, Wenyuan Ding, Yong Shen
    Abstract:

    RATIONALE Degloving Injury of the upper limb often extends to underlying tendons and bone, which is at high risk of treatment failure if only simple reattachment of defatted avulsed skins was performed. Pelnac dermal regeneration template could be used as a treatment choice for necrosis of the reattached avulsed skins in a Degloving Injury. PATIENT CONCERNS A 48-year-old woman with a Degloving Injury of the right forearm, wrist, and hand received initial treatment by reattachment of the defatted avulsed skins over the wound bed. However, 17 days postoperatively, the reattached skins developed complete necrosis, leaving large size of tissue defects and tendon/bone exposure. DIAGNOSIS Failure to reconstruct the skin and soft-tissue envelop by reattachment of the defatted avulsed skins in a severe Degloving Injury of the upper limb. INTERVENTIONS We decided to use a 2-stage procedure of Pelnac dermal regeneration template and secondary skin graft to solve this issue, in consideration of these conditions and the patient' demanding of limb function and aesthetic appearance. OUTCOMES At the final follow-up, this patient obtained an excellent result, in term of scar quality, aesthetic appearance, and the ability to perform the daily activities. LESSONS We believe this could become an interesting option in patients who needed revision procedure for management of complex wounds with tendon/bone exposure following the necrosis of reattached skins in Degloving injuries.

Dequn Liu - One of the best experts on this subject based on the ideXlab platform.

  • treatment of thumb tip Degloving Injury using the modified first dorsal metacarpal artery flap
    Journal of Hand Surgery (European Volume), 2010
    Co-Authors: Chao Chen, Shunhong Gao, Bin Wang, Xu Zhang, Xinzhong Shao, Dequn Liu
    Abstract:

    Purpose This study reports repair of a thumb tip Degloving Injury using the modified first dorsal metacarpal artery (FDMA) flap, including both dorsal branches of the proper digital nerve (DBPDNs). Methods From May 2006 to February 2008, the modified FDMA flap was used in 11 thumbs in 11 patients. All patients suffered a Degloving Injury to the thumb tip, and 4 had associated bone loss ranging from 1 to 3 mm (mean, 2 mm) in length. The size of the soft tissue defects was 2.6 to 4.6 cm (mean, 3.5 cm) in length and 1.8 to 2.2 cm (mean, 2.0 cm) in width. The flaps ranged in size from 2.7 × 2.2 cm to 4.8 × 2.1 cm (mean, 3.6 × 2.1 cm). The mean pedicle length was 7.2 cm (range, 6.8–7.5 cm). Neurorrhaphy between the DBPDN and the proper digital nerve was performed in both sides in all cases. Patient follow-ups ranged from 26 to 47 months (mean, 32 mo). Sensibility of the reconstructed thumb was evaluated by static 2-point discrimination. The range of motion of the donor fingers was measured. The data were compared to those of the opposite sides. Results All flaps survived completely. At the final follow-up, the mean values of static 2-point discrimination were 5 mm (range, 4–8 mm) and 6 mm (range, 4–8 mm) on the radial and ulnar sides of the distal portion of the flap, respectively. The mean values of the radial and ulnar distal portions of the flaps reached 75% and 72% of those of the opposite sides. The mean range of motion of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints of the donor fingers were 73°, 101°, and 70°, respectively. Conclusions The modified FDMA flap, including both DBPDNs, is useful for restoration of sensation on the thumb tip and maintenance of adequate length of the thumb. Type of study/level of evidence Therapeutic IV.