Artikel
Percutaneous collagen induction for injured fingertip remodeling
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Veröffentlicht: | 3. September 2014 |
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Gliederung
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Introduction: Reconstructive surgical interventions at the level of the fingertip are challenging due to the delicate anatomical site. Full functional reconstitution with adequate grip, strength and sensibility is infrequently achieved with often dissatisfying results, mostly due to scarring. Here we present a case report in which a combination of multiple methods are applied resulting in promising results.
Case Report: In 2008 a 47 year old man complains of pain of the right middle finger. After a felon operation in 2005 scarring with insufficient soft tissue coverage at the finger tip led to severe impairment in the use of the finger. The patient was currently working as a professional bass player and depends on the painless functionality of the middle finger to make a living.
In 2008 tissue augmentation at the finger tip was performed by two lateral VY-Kutler flaps in combination with a adipofascial turnover flap. This resulted in a transient amelioration and pain relief. In 2010, the functionality was restrained again, mostly because of the recurrent new scarring. We then performed a percutaneous collagen induction (PCI) through application of a 3 mm needled roller for the high frequency microneedle perforation of the skin at the fingertip. A four year follow up period showed a permanent satisfactory result with 80% regain of former functionality and full exertion of the patient’s profession as a bass player.
Conclusion: PCI is a promising therapeutic option in patients with scar related symptoms especially in anatomically delicate regions as fingertips and can easily be combined with additional techniques.