Long-term outcome of neurovascular palmar advancement flaps for distal thumb injuries

Thirteen neurovascular palmar flaps for thumb tip coverage were reviewed: s ix O'Brien and seven Moberg flaps with a mean follow-up of 81 months. Both techniques were found to be safe and effective in preserving pulp sensibili ty, with a mean 2PD of 5 mm and a Semmes-Weinstein identical to the contral ateral side in nine cases. The interphalangeal joint regained a normal rang e of motion, and did not seem to be affected by the perioperative flexion. The main residual complaints were persistent cold intolerance (present in a ll cases and severe in three), pulp instability (present in six and severe in two), and nail deformity. This last problem was more related to the inju ry. Despite these drawbacks, O'Brien and Moberg flaps remain the first choi ce for coverage of 1-2 cm pulp defects of the thumb.