Sensory rehabilitation of the heterodigital neurovascular island skin flap for the thumb

Abstract EN

Objectives : The loss of sensibility of the thumb is a major disability.

Since littler (1956) described his neurovascular island flap (NVIF), two main problems have arisen calling for repeated attempts at modifying the technique to overcome these two problems, viz.

Double sensibility and referral of sensibility in the graft to the donor finger.

Our work aimed at studying the impact of a suggested rehabilitation program on sensory outcome following NVIF for thumb.

Methodology : this study included 23 patients and 25 controls, all were operated upon using the original Litter's Technique.

This was followed by a specially designed rehabilitation program for the study group.

The rehabilitation program consisted of low frequency electric stimulation combined with special methods of sensory reeducation.

This program started 30 days after surgery and was continued for two months.

Assessment was done at 3, 6, 12 and 18 months postoperative.

Results : At 18 months postoperative the switch of sensibility was improved from 48 % in the controls to 82 % in the study group.

The double sensibility was reduced from 36 % in the controls to 13.6 % in the study group.

Conclusions : we conclude that in our study the sensory outcome following the NVIF for thumb improved with the use of our suggested rehabilitation program.