ABSTRACT
The problems of late deterioration of sensation and a “double sensibility” phenomenon,
either in the thumb or donor finger, are a known deficiency of the conventional heterodigital
neurovascular island flap. This is probably related to unsatisfactory cortical reorientation
following flap transfer. To obviate this problem, the authors have used a disconnection/reconnection
technique for heterodigital island flaps in 17 patients, to resurface defects in the
skin of the thumb. All patients were followed-up for 1 year, while 15 were followed-up
for 2 years or more. There were no flap complications or failures, and the length
of the thumb tip was preserved in all cases. The classic two-point discrimination
was less than 6 mm in eight of these patients, and the remaining nine patients had
two-point discrimination of between 6 and 8 mm. This technique was found to provide
sensitive, supple, and well-vascularized skin with proper cortical representation,
to replace the loss of the tactile pulp of the thumb tip in one operative stage.
