Not Just for Kids: A Systematic Review of Outcomes of the Thenar Flap.
Camren S Toole, Carlos R Martinez, Joshua M Adkinson
✦ AI-curated · Sources linked
In 30 seconds
This systematic review assessed functional outcomes after thenar flap reconstruction for fingertip injuries, focusing on whether patients aged 30 years and older face greater risk of joint contracture. Across 15 studies involving 519 flaps, joint contracture occurred in 32.4% of cases and was limited to the distal interphalangeal (DIP) joint. Metacarpophalangeal and proximal interphalangeal motion remained near normal and comparable with the opposite finger; DIP active range of motion was 14.1° lower. The review found no significant increase in contracture risk among patients older than 30 years.
Key findings
- Joint contracture occurred in 32.4% of cases; all contractures involved the DIP joint.
- DIP active range of motion was reduced by 14.1° compared with contralateral fingers.
- Patients older than 30 years had 3° greater PIP active range of motion than younger patients (P = .02).
- Metacarpophalangeal and PIP active range of motion remained near normal and comparable with contralateral fingers.
Why it matters
The review addresses a common concern that thenar flaps may cause contracture in adults aged 30 years and older. Its findings suggest that the observed contractures were confined to the DIP joint and that older age was not associated with a significantly greater contracture risk. This helps frame functional trade-offs when considering a technique intended to preserve fingertip length.
What to keep in mind
The review included non-randomized studies, and the authors recommend larger studies with standardized outcome assessment.