Clinical characteristics and outcomes of reconstruction of thumb soft tissue defects at Viet Duc Hospital
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Abstract
Objectives: To evaluate the clinical characteristics of thumb soft tissue defects and the outcome of flap reconstruction at Viet Duc Hospital
Subjects and Methods: A descriptive case-series study with longitudinal follow-up, combining retrospective and prospective data collection, was conducted on 34 patients with thumb soft tissue defects who underwent flap reconstruction at the Department of Maxillofacial, Plastic and Aesthetic Surgery, Viet Duc Hospital from January 2020 to December 2025. Clinical characteristics, defect morphology, reconstructive techniques, and treatment outcomes were analyzed.
Results: Male patients accounted for 76.5% of cases, with a mean age of 43 ± 16 years. Occupational injuries were the leading cause of thumb defects (64.7%). Defects were most commonly located in the distal third of the thumb (73.5%) and presented predominantly as volar oblique injuries (61.8%). Associated injuries to bone, tendon, and joint were observed in 38.2%, 29.4%, and 35.3% of patients, respectively. The most frequently utilized reconstructive technique was antegrade first dorsal metacarpal artery flap (55.9%), followed by free SCIP flap (20.6%). Complete flap survival was achieved in 97.1% of cases, with only one partial flap necrosis involving less than one-third of the flap area. Flat scars were observed in 91.2% of donor sites and 94.1% of recipient sites. Normal thumb contour and nail appearance were achieved in 97.1% and 82.4% of patients, respectively. Good functional recovery according to the Kapandji score was obtained in 76.5% of patients, while BMRC grade S3+ sensory recovery was the most common outcome (58.8%). Overall patient satisfaction was high, with 91.2% reporting satisfaction or high satisfaction.
Conclusion: Flap reconstruction is an effective method for managing thumb soft tissue defects, providing a high flap survival rate, satisfactory functional and aesthetic outcomes, and high patient satisfaction.
Keywords
Thumb, soft tissue defect, flap reconstruction, hand reconstruction
Article Details
References
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