The Neurovascular Island Pedicle Flap

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Abstract
Sensation, circulation, and durability of neurovascular island flaps in the thumb were assessed in sixteen patients one to ten years after surgery. The incidence and significance of complications were noted. Based on two-point discrimination and touch, the sensation in the neurovascular island flap of these patients was less than normal when the flap was carried on a single pedicle. The sensation was normal in one patient whose neurovascular flap comprised the whole volar surface of the donor finger supplied by both neurovascular bundles. As a rule the neurovascular flap provided an excellent durable tactile surface with sensation useful for gross grips. Cold intolerance did not appear to be affected by a neurovascular island transfer. Hyperesthesia occurred in seven of the sixteen patients for varying periods of time. It nullified the functional benefits of the operation. Reorientation of the localization of stimuli applied to the flap from the donor to the recipient site occurred in four patients only after long periods ranging from eighteen months to eight years. However, function was not adversely affected if this reorientation had not occurred.

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