Study of the role of heterodigital pedicled proximally based neurovascular island flap in reconstruction and complex complicated composite volar thumb injuries

This article deals with various complex, composite soft tissue defects of thumb being aptly resurfaced using pedicled Littler’s neurovascular island flap. The study was conducted from January 2016 to January 2019 in our Institution. Around 40 patients of thumb injuries with loss of skin, soft tissue, nail and nail bed complex, part of terminal phalanx were examined, reconstruction done using with V-Y advancement flap, Moberg’s advancement flap, Cross finger flap from Index finger, Littler’s neurovascular island flap technique based on a single neurovascular pedicle. Post operative physiotherapy is given with full active range of movements of both the donor and the recipient sites. In this survey all flaps the survived, achieved normal or adequate 2 point discrimination without any painful scar or cold hypersensitivity. Managing complex volar soft tissue defects of the thumb using proximally based Littler’s, neurovascular island flap is an ideal choice with anatomical restoration, good functional recovery, good patient satisfaction.