Donor Finger Morbidity in Cross-Finger Flap: A Systematic Review and Meta-Analysis

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India · 6 authors, 6 centres

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TL;DR

This systematic review and meta-analysis evaluated donor finger morbidity in 279 patients across 16 studies of cross-finger flap reconstruction. It found no significant impairment in the range of motion of the donor finger, but noted apparent impairments in sensory recovery and cosmetic outcomes that require further objective evaluation.

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A systematic review and meta-analysis following PRISMA protocols and registered with PROSPERO included 16 studies objectively evaluating donor finger morbidity in 279 patients after cross-finger flap surgery. The middle finger was the most common donor. However, sensory recovery was impaired, with a weighted mean static two-point discrimination of 8.84 mm in 138 donor fingers. Limitations included high heterogeneity, varying follow-up periods, inconsistent outcome measures, and the absence of individual patient data for confounding factors. The findings suggest donor finger mobility is not significantly affected, but sensory and aesthetic outcomes warrant further objective study.

STUDY TYPE

meta-analysis

SPECIALTY

surgery

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ORIGINAL PAPER

PMC10332906

Donor Finger Morbidity in Cross-Finger Flap: A Systematic Review and Meta-Analysis

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India

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ABSTRACT

Background The morbidity of donor finger in a cross-finger flap has not received as much importance as the outcomes of the flap itself. The sensory, functional, and aesthetic morbidity of donor fingers, reported by various authors, are often contradictory to each other. In this study, objective parameters for the sensory recovery, stiffness, cold intolerance, cosmetic outcome, and other complications in the donor fingers, reported in the previous studies, are systematically evaluated. Methods This systematic review is reported using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol and was registered with the International prospective register of systematic reviews (PROSPERO registration no. CRD42020213721). Literature search was done using “cross-finger,” “heterodigital,” “donor finger,” and “transdigital” words. Data regarding demography, patients' number and age, follow-up duration and outcomes of donor finger, including 2-point discrimination, range of motion (ROM), cold intolerance, questionnaires, etc. were extracted from included studies. Meta-analysis was performed using MetaXL and risk of bias was evaluated using Cochrane risk of bias tool. Results Out of the total 16 included studies, 279 patients were objectively evaluated for donor finger morbidity. Middle finger was most frequently used as donor. Static two-point discrimination seemed to be impaired in donor finger in comparison to contralateral finger. Meta-analysis of ROM suggested that statistically there is no significant difference in ROM of interphalangeal joints in donor and control fingers (pooled weighted mean difference: −12.10; 95% confidence interval: −28.59, 4.39; I2 = 81%, n = 6 studies). One-third of donor fingers had cold intolerance. Conclusion There is no significant effect on ROM of donor finger. However, the impairment that seems to be in sensory recovery and aesthetic outcomes needs to be further evaluated objectively.

CITATION EXPORT

Sourabh Shankar Chakraborty, Ranjit Kumar Sahu, Sudeshna Acharya et al.. Donor Finger Morbidity in Cross-Finger Flap: A Systematic Review and Meta-Analysis. Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India. (2023). https://doi.org/10.1055/s-0042-1760092

AUTHORS

6 · 6 CENTRES

Sourabh Shankar Chakraborty, Ranjit Kumar Sahu, Sudeshna Acharya, Akhil Dhanesh Goel, Manojit Midya, Suresh Kotu

1Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Kalyani, Nadia, West Bengal, India
2Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
3Department of Trauma & Emergency, Burdwan Medical College, Bardhaman
4Department of Community Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
5Plastic & Reconstructive Surgery Department, Government Medical College, Kota, Rajasthan, India
6Department of Burns and Plastic Surgery, GSL Medical College, Rajahmundry, Andhra Pradesh, India