Sensory Evaluation of Post Traumatic Thumb after Reconstruction with Reverse Radial Forearm Flap

Background: Thumb is with a special role in hand function. Therefore, in addition to the significance of using thin, pliable, color-matched, and hairless cover in resurfacing the lesion in this area, recovery of sensation should also be taken into consideration. Materials and Methods: Thirteen patients with thumb degloving injuries were candidates for sensate reverse island radial forearm surgery. After transferring the flap, forearm lateral sensory nerve was sewn to the thumb digital nerve. At least for two years, these patients received regular diagnosis, and monofilament, static two point discrimination (S-2PD), and moving two point discrimination (M-2PD) tests were taken from them. Results: Monofilament test did not show normal sensation recovery, at protective sensation threshold, in the parents. The difference between monofilament test and normal thumb was statistically significant (p < 0.0001). In spite of this, the protective sensation was restored in all flaps after two years. According to the results from S-2PD and M-2PD tests, the restored sensation was at protective threshold or reduced, and the difference was statistically significant (p < 0.0001). Conclusion: Given difficulties of performing free flaps, and also deficiencies of pedicle flaps, the forearm radial island flap is known as one of the primary choices in most of the thumb soft tissue and hand defects reconstruction, due to its advantages, especially restoring the sensation of the injured site.