Kite String or Manja Cut Injury: A New Culprit.

Background Kite string injuries (manja cut injuries), particularly those caused by Chinese manja, are new culprit of emergencies especially in the month of January in Maharashtra region. These injuries commonly affect the neck, face, hands, and legs, especially among individuals traveling on two wheelers. The visibility challenge, where the kite's thread is difficult to see, further exacerbates the risk. Materials and Methods We have studied 10 cases of manja cut injuries presented to a tertiary care center in Nagpur during the last 2 years. Result A total of 10 patients reported kite string-related injuries to our department over a period of 2 years. All patients were male. The majority of patients presented in the younger age group with the mean age of presentation was 25 years. Majority of the patients had injuries in zone 2 of the hand. Conclusion Kite flying is a traditional festival celebrated in the month of January in Gujarat and Maharashtra for years. However, the introduction of Chinese or nylon manja has led to serious injuries and fate, affecting not only kite flyers but also bystanders, animals, and birds. This study seeks to highlight the harmful consequences of Chinese manja and deceptive appearance of manja giving false impression of simple lacerated wound which could be just a tip of the iceberg.

Decoding disorder signatures of AuCl3and vacancies in MoS2films: from synthetic to experimental inversion.

This study investigates the scope of application of a recently designed inversion methodology that is capable of obtaining structural information about disordered systems through the analysis of their conductivity response signals. Here we demonstrate that inversion tools of this type are capable of sensing the presence of disorderly distributed defects and impurities even in the case where the scattering properties of the device are only weakly affected. This is done by inverting the DC conductivity response of monolayered MoS2films containing a minute amount of AuCl3coordinated complexes. Remarkably, we have successfully extracted detailed information about the concentration of AuCl3by decoding its signatures on the transport features of simulated devices. In addition to the case of theoretically generated Hamiltonians, we have also carried out a full inversion procedure from experimentally measured signals of similar structures. Based on experimental input signals of MoS2with naturally occurring vacancies, we were able to quantify the vacancy concentration contained in the samples, which indicates that the inversion methodology has experimental applicability as long as the input signal is able to resolve the characteristic contributions of the type of disorder in question. Being able to handle more complex, realistic scenarios unlocks the method's applicability for designing and engineering even more elaborate materials.

Kite Versus Ponseti Method in the Treatment of Idiopathic Congenital Clubfoot: A Systematic Review and Meta-Analysis.

Kite and Ponseti methods are two popular manipulating methods for correcting the deformity of idiopathic congenital clubfoot. We aimed to compare the efficacy of Kite and Ponseti methods in the treatment of children with idiopathic congenital clubfoot. A search was launched on Medline/PubMed, Cochrane Central Register of Controlled Trials, the Web of Science, ProQuest, and Scopus without limits, from inception to May 1, 2024. The outcomes included the rates of initial correction and relapse (primary) as well as the number of casts and duration of treatment (secondary). Mean difference (MD) and risk ratio (RR) were calculated for numerical and dichotomous outcomes, respectively, with 95% confidence intervals (CIs). Nine studies were included. Meta-analysis showed the Ponseti method is significantly associated with a higher probability of correction (n = 6, RR = 1.23 [95% CI = 1.14, 1.32], p < 0.001) and a lower risk of relapse (n = 5, RR = 0.50 [95% CI = 0.36, 0.71], p < 0.001) compared to the Kite method. The Ponseti method utilized a lower number of casts (MD = -3.0 [95% CI = -5.8, -0.2], p = 0.04) and took a shorter duration (MD = -39.76 [95% CI = -67.22, -12.30], p = 0.02) than the Kite method. Evidence suggests that the Ponseti method results in better outcomes than the Kite method in terms of successful initial correction and lower relapse rates. However, the available studies showed varying degrees of risk of bias, and the length of follow-up was inadequate in some studies.

Health Effects of Patagial Wing Tags in Red Kites (Milvus milvus) in the UK.

Patagial wing tags are commonly used for identification of Red Kites (Milvus milvus) for postrelease monitoring, as they are easy to apply, affordable, permanent, and are apparently safe. The Red Kite was successfully reintroduced in the UK in the second half of the 20th century and postrelease health surveillance has been achieved through radio and satellite tracking, monitoring nest sites, and pathologic investigation of Red Kites found dead. This study reports on pathologic findings associated with the use of patagial wing tags in three of 142 (2.1%) wing-tagged Red Kites examined postmortem since the beginning of the reintroduction project in 1989. In these three Red Kites the presence of the patagial wing tags was associated with inflammatory lesions. Further surveys of the potential short- and longer-term negative effects of patagial wing tags on Red Kites and other birds are advocated; the future use of patagial wing tags in raptors should be carefully monitored.

Application of Modified Kite Flap in Reconstruction of Facial Wounds After Operation and Case Series.

Our team used a new kite flap preparation method to repair wounds after the removal of a benign facial tumor with satisfactory aesthetic results. Thus, this modified kite flap has significant value in facial trauma repair.

Sustained Disease Control in DME Patients upon Treatment Cessation with Brolucizumab.

Background: Treatment cessation due to a dry retina has not been systematically addressed in diabetic macular edema (DME). In three out of four patients receiving 6 mg of brolucizumab in the KITE study, treatment was terminated after the study ended. Methods: The KITE study was a double-masked, multicenter, active-controlled, randomized trial (NCT03481660) in DME patients. Per protocol, patients received five loading injections of Brolucizumab at 6-week intervals, with the option to adjust to 8 weeks in case of disease activity or to extend in the second year to a maximum of 16 weeks in the absence of retinal fluid. Results: After two years, one patient required eight weekly injections, while three patients reached a maximal treatment interval of 16 weeks. The severity of diabetic retinopathy improved in all patients with no dye leakage according to fluorescein angiography (FA) and no retinal fluid according to OCT in three patients. Treatment was paused in these three patients for >36 months, while the fourth patient required continuous treatment at 5-week intervals after switching to other licensed anti-VEGF agents. Conclusions: The adoption of treatment according to individual needs, including considering treatment cessation, may contribute to improved treatment adherence in many patients and be more frequently possible than expected.

The Application of Modified Kite Flap: A Novel Technique for Reconstruction of Defects in Areas with High Tension.

Objective: It is challenging to reconstruct defects resulting from surgical procedures in areas with high tension. We present modified kite flaps that allowed us to reconstruct the defect with high mechanical tension. Methods: With the combination of advancement and rotation, the defect using bilateral modified kite flaps closes with significantly reduced tension. The double flap not only advances but also rotates the flap. This technique retained and exploited the limbs of the flaps, which were often removed with the traditional V-Y flaps. Results: Eleven patients have had their surgical defects repaired using this technique, and the results were satisfactory. A follow-up period of three months or longer was conducted. There were no perioperative complications, and major anatomic landmarks were reconstructed. All patients were satisfied with the functional recovery. Conclusion: The modified method enables a significantly shortened advancement distance of flaps, more flexible flap movement, and sacrifice of healthy tissue to be minimal, and significantly diminished tension for closure. Approximately half the width and length of traditional V-Y flaps were used in this flap donor. Preserving the flap limbs, which were often removed with the traditional V-Y flaps, was also applied to fill defects. Modified kite flaps are a suitable option for the repair of defects in areas with high tension.

Kitesurfing and snowkiting injuries in Norway: a retrospective study.

BACKGROUND: Kiteboarding (kitesurfing on water and snowkiting) is a fairly new sport and is defined as a high-risk sport. The injury rate has been reported to be between 6 and 9 per 1000 h. The aim of the study was to identify and describe kiteboarding-related injuries in Norway over a five-year period. METHODS: We used "snowball sampling" to identify kiteboarding accidents in a retrospective study. In addition, we conducted structural searches in the National Air Ambulance Service and Search and Rescue Helicopter patient record databases. All included informants were interviewed. Descriptive methods were used to characterise the sample. RESULTS: Twenty-nine kiteboarders were included, with a total of 33 injuries. One half of the injuries to head, face and neck were cerebral concussions (n = 12). The most common type of injury was bone fractures (n = 28), followed by soft tissue injuries (n = 24). Most injuries were of moderate severity (51%) and falling from less than 5 m was the most common mechanism of injury. Operator error and lack of experience were the most frequently reported causes of accidents (82%). CONCLUSIONS: Serious injuries occured during kiteboarding. The majority of kiteboarders reported operator error or lack of experience as the cause of their accident. Prior to kiteboarding, a course highlighting the importance in using helmet for snowkiting and both helmet and life vest in kitesurfing, should be mandatory.

Sex and size shape the ontogeny of partial migration.

The arrival-time hypothesis of partial seasonal migration proposes that over-winter residence is driven by reproductive benefits of early presence on the breeding grounds. Thus, it predicts increased occurrence of residence at reproductive age. In contrast, the body size hypothesis proposes age-independent benefits of residence for large individuals, who should exhibit greater winter tolerance. Despite different expectations in age patterns for the two hypotheses in long-lived partially migrant species, there is little empirical work investigating the ontogeny of migratory phenotypic expression, that is the expression of residence or migration. We investigated the influence of age, sex and body size on migratory phenotype throughout ontogeny (from first year to early adulthood) in a long-lived partially migrant species, the red kite Milvus milvus. We GPS-tracked 311 individuals tagged as juveniles and 70 individuals tagged as adults over multiple years, yielding 881 observed annual cycles. From this data, we estimated age-dependent probabilities of the transition to residence and of survival in migrants and residents using a Bayesian multistate capture-recapture model, as well as the probability of resuming migration once resident. We then calculated the resulting proportion of residents per age class. In both sexes, almost all juveniles migrated in their first winter, after which the probability of becoming resident gradually increased with age class to approximately 0.3 in adults (>3 calendar years). A size effect in third calendar year females suggests that large females adopt residence earlier in life than small females. The transition from residence back to migration only occurred with a probability of 0.15 across all resident individuals. In addition, survival was notably reduced in adult male migrants compared to adult male residents. These results are largely consistent with the arrival-time and body size hypotheses, simultaneously. Our results reveal a plastic, yet primarily directional within-individual change in migratory phenotype towards more residence with increasing age, varying between sexes and between individuals of different size. This study highlights that different individual characteristics can jointly shape the ontogeny of migratory behaviour and result in complex within-population patterns and persistence of migratory phenotypes.

Biosynthesis of eriodictyol in citrus waster by endowing P450BM3 activity of naringenin hydroxylation.

The flavonoid naringenin is abundantly present in pomelo peels, and the unprocessed naringenin in wastes is not friendly for the environment once discarded directly. Fortunately, the hydroxylated product of eriodictyol from naringenin exhibits remarkable antioxidant and anticancer properties. The P450s was suggested promising for the bioconversion of the flavonoids, but less naturally existed P450s show hydroxylation activity to C3' of the naringenin. By well analyzing the catalytic mechanism and the conformations of the naringenin in P450, we proposed that the intermediate Cmpd I ((porphyrin)Fe = O) is more reasonable as key conformation for the hydrolyzation, and the distance between C3'/C5' of naringenin to the O atom of CmpdI determines the hydroxylating activity for the naringenin. Thus, the "flying kite model" that gradually drags the C-H bond of the substrate to the O atom of CmpdI was put forward for rational design. With ab initio design, we successfully endowed the self-sufficient P450-BM3 hydroxylic activity to naringenin and obtained mutant M5-5, with kcat, Km, and kcat/Km values of 230.45 min-1, 310.48 µM, and 0.742 min-1 µM-1, respectively. Furthermore, the mutant M4186 was screened with kcat/Km of 4.28-fold highly improved than the reported M13. The M4186 also exhibited 62.57% yield of eriodictyol, more suitable for the industrial application. This study provided a theoretical guide for the rational design of P450s to the nonnative compounds. KEY POINTS: •The compound I is proposed as the starting point for the rational design of the P450BM3 •"Flying kite model" is proposed based on the distance between O of Cmpd I and C3'/C5' of naringenin •Mutant M15-5 with 1.6-fold of activity than M13 was obtained by ab initio modification.

Soaring over open waters: horizontal winds provide lift to soaring migrants in weak thermal conditions.

BACKGROUND: For soaring birds, the ability to benefit from variable airflow dynamics is crucial, especially while crossing natural barriers such as vast water bodies during migration. Soaring birds also take advantage of warm rising air, so-called thermals, that allow birds to ascend passively to higher altitudes with reduced energy costs. Although it is well known that soaring migrants generally benefit from supportive winds and thermals, the potential of uplifts and other weather factors enabling soaring behavior remains unsolved. METHODS: In this study, we GPS-tracked 19 Red Kites, Milvus milvus, from the Central European population that crossed the Adriatic Sea on their autumn migration. Migratory tracks were annotated with weather data (wind support, side wind, temperature difference between air and surface-proxy for thermal uplift, cloud cover, and precipitation) to assess their effect on Red Kites' decisions and soaring performance along their migration across the Adriatic Sea and land. RESULTS: Wind support affected the timing of crossing over the Adriatic Sea. We found that temperature differences and horizontal winds positively affected soaring sea movement by providing lift support in otherwise weak thermals. Furthermore, we found that the soaring patterns of tracked raptors were affected by the strength and direction of prevailing winds. CONCLUSION: Thanks to modern GPS-GSM telemetry devices and available data from online databases, we explored the effect of different weather variables on the occurrence of soaring behavior and soaring patterns of migratory raptors. We revealed how wind affected the soaring pattern and that tracked birds could soar in weak thermals by utilizing horizontal winds, thus reducing energy costs of active flapping flight over vast water bodies.

The genome sequence of the Kite-tailed Robberfly, Machimus atricapillus (Fallén, 1814).

We present a genome assembly from an individual male Machimus atricapillus (the Kite-tailed Robberfly; Arthropoda; Insecta; Diptera; Asilidae). The genome sequence is 268.6 megabases in span. Most of the assembly is scaffolded into six chromosomal pseudomolecules, including the X and Y sex chromosomes. The mitochondrial genome has also been assembled and is 16.3 kilobases in length. Gene annotation of this assembly on Ensembl identified 10,978 protein coding genes.

Screening and Functional Analyses of Novel Cecropins from Insect Transcriptome.

Antibiotic resistance is a significant and growing threat to global public health. However, antimicrobial peptides (AMPs) have shown promise as they exhibit a broad spectrum of antibacterial activities with low potential for resistance development. Insects, which inhabit a wide range of environments and are incredibly diverse, remain largely unexplored as a source of novel AMPs. To address this, we conducted a screening of the representative transcriptomes from the 1000 Insect Transcriptome Evolution (1KITE) dataset, focusing on the homologous reference genes of Cecropins, the first identified AMPs in insects known for its high efficiency. Our analysis identified 108 Cecropin genes from 105 insect transcriptomes, covering all major hexapod lineages. We validated the gene sequences and synthesized mature peptides for three identified Cecropin genes. Through minimal inhibition concentration and agar diffusion assays, we confirmed that these peptides exhibited antimicrobial activities against Gram-negative bacteria. Similar to the known Cecropin, the three Cecropins adopted an alpha-helical conformation in membrane-like environments, efficiently disrupting bacterial membranes through permeabilization. Importantly, none of the three Cecropins demonstrated cytotoxicity in erythrocyte hemolysis tests, suggesting their safety in real-world applications. Overall, this newly developed methodology provides a high-throughput bioinformatic pipeline for the discovery of AMP, taking advantage of the expanding genomic resources available for diverse organisms.

Bird flight behavior, collision risk and mitigation options at high-speed railway viaducts.

High-speed railway (HSR) networks are rapidly expanding and are predicted to continue to grow over coming decades. However, there is scant knowledge of their environmental impacts. Their possible effects on bird mortality, particularly at viaducts, gives especial cause for concern. This work presents the results of a nine-month monitoring of bird activity in the vicinity of three HSR viaducts in Central Spain. The study focused on the effects of the infrastructure regarding bird frequentation of the site and on bird flight activity in the danger zone for collision with passing trains. The findings show (i) that bird communities may differ markedly between sites and (ii) that bird activity increases near the railway together with changes in relative species abundances. Furthermore, (iii) birds show a significant tendency to avoid flying across the danger zone, but (iv) all kinds of birds are at a real risk of collisions with trains at viaducts. The greatest danger is at viaduct extremes rather than in their central section, particularly during gusts of wind and for small or medium-sized birds. It also appears that relatively low viaducts might pose greater risk. In practical terms, these results (i) emphasise the need for thorough prior prospection of bird species present, and their flight patterns, where new viaducts are to be built, (ii) show that there is a real risk of bird collisions with trains at viaducts, which should be mitigated, with particular attention due to viaduct extremes and areas where their height is not much above the surrounding vegetation and (iii) strongly indicate the need to minimise viaduct features that may attract birds to them, for example as potential nest sites.

The variability of juvenile dispersal in an opportunistic raptor.

The juvenile dispersal of raptors is a crucial stage that stretches from parental independence to the establishment of the first breeding area. Between 2012 and 2020, 44 juvenile red kites Milvus milvus from the Spanish breeding population were tagged using GPS telemetry to study their dispersal. Juveniles left the parental breeding area at the end of their first summer and performed wandering movements throughout the Iberian Peninsula, returning to the parental breeding area the following year, repeating the same pattern until they settled in their first breeding area. We analyzed the mean distance from the nest, the maximum reached distances, and the traveled distances (daily and hourly) during the first 2 years of dispersal and compared them. Despite the high individual variability, variables describing the dispersal movements of juveniles showed a decreasing trend during the second dispersal year: 80% of individuals reached a shorter maximum distance in the second year, 70% decreased their mean distance to the nest, 65% decreased their hourly traveled distances, and 50% decreased their daily traveled distances. On the other hand, the red kites usually combined wandering movements with the establishment of temporary settlement areas (TSA). The average duration of settlement in the TSAs was 75 ± 40 days (up to 182 days) and was located at 182 ± 168 km from the nest. In those areas, juveniles used 781.0 ± 1895.0 km2 (KDE 95%). Some of the TSAs were used by several individuals, which suggests that these areas might be good targets for conservation in future management plans.

The SAGA histone acetyltransferase module targets SMC5/6 to specific genes.

BACKGROUND: Structural Maintenance of Chromosomes (SMC) complexes are molecular machines driving chromatin organization at higher levels. In eukaryotes, three SMC complexes (cohesin, condensin and SMC5/6) play key roles in cohesion, condensation, replication, transcription and DNA repair. Their physical binding to DNA requires accessible chromatin. RESULTS: We performed a genetic screen in fission yeast to identify novel factors required for SMC5/6 binding to DNA. We identified 79 genes of which histone acetyltransferases (HATs) were the most represented. Genetic and phenotypic analyses suggested a particularly strong functional relationship between the SMC5/6 and SAGA complexes. Furthermore, several SMC5/6 subunits physically interacted with SAGA HAT module components Gcn5 and Ada2. As Gcn5-dependent acetylation facilitates the accessibility of chromatin to DNA-repair proteins, we first analysed the formation of DNA-damage-induced SMC5/6 foci in the Δgcn5 mutant. The SMC5/6 foci formed normally in Δgcn5, suggesting SAGA-independent SMC5/6 localization to DNA-damaged sites. Next, we used Nse4-FLAG chromatin-immunoprecipitation (ChIP-seq) analysis in unchallenged cells to assess SMC5/6 distribution. A significant portion of SMC5/6 accumulated within gene regions in wild-type cells, which was reduced in Δgcn5 and Δada2 mutants. The drop in SMC5/6 levels was also observed in gcn5-E191Q acetyltransferase-dead mutant. CONCLUSION: Our data show genetic and physical interactions between SMC5/6 and SAGA complexes. The ChIP-seq analysis suggests that SAGA HAT module targets SMC5/6 to specific gene regions and facilitates their accessibility for SMC5/6 loading.

Determinants of departure to natal dispersal across an elevational gradient in a long-lived raptor species.

Attributes of natal habitat often affect early stages of natal dispersal. Thus, environmental gradients at mountain slopes are expected to result in gradients of dispersal behavior and to drive elevational differences in dispersal distances and settlement behavior. However, covariation of environmental factors across elevational gradients complicates the identification of mechanisms underlying the elevational patterns in dispersal behavior. Assuming a decreasing food availability with elevation, we conducted a food supplementation experiment of red kite (Milvus milvus) broods across an elevational gradient toward the upper range margin and we GPS-tagged nestlings to assess their start of dispersal. While considering timing of breeding and breeding density across elevation, this allowed disentangling effects of elevational food gradients from co-varying environmental gradients on the age at departure from the natal home range. We found an effect of food supplementation on age at departure, but no elevational gradient in the effect of food supplementation. Similarly, we found an effect of breeding density on departure age without an underlying elevational gradient. Supplementary-fed juveniles and females in high breeding densities departed at younger age than control juveniles and males in low breeding densities. We only found an elevational gradient in the timing of breeding. Late hatched juveniles, and thus individuals at high elevation, departed at earlier age compared to early hatched juveniles. We conclude that favorable natal food conditions, allow for a young departure age of juvenile red kites. We show that the elevational delay in breeding is compensated by premature departure resulting in an elevational gradient in departure age. Thus, elevational differences in dispersal behaviour likely arise due to climatic factors affecting timing of breeding. However, the results also suggest that spatial differences in food availability and breeding density affect dispersal behavior and that their large-scale gradients within the distributional range might result in differential natal dispersal patterns.

Kite subcutaneous pedicle flap design in postoperative defect repair of nasal skin cancer based on partition and blood supply / 中华医学美学美容杂志

Objective:To investigate the clinical effect of repairing postoperative nasal skin cancer defect with subcutaneous pedicle flap based on partition and blood supply.Methods:From March 2018 to September 2020, 39 patients with skin cancer (basal cell carcinoma, Bowen′s disease, squamous cell carcinoma and malignant melanoma in situ) were repaired with kites subcutaneous pedicle flap after extensive resection.Results:Thirty-nine patients were treated with parafasal kite flaps, including 44 cases. The donor sites of the flap were nasal tip in 4 cases, bilateral alar in 7 cases, bilateral nasolabial sulcus in 19 cases, bilateral parasinal in 12 cases and interglabellar in 2 cases. There were no serious complications such as necrosis, hematoma or infection. During the follow-up period of 6 to 24 months, 2 patients complained of occasional tingling in the surgical area, 1 complained of occasional pruritus, and 1 patient had local recurrence of squamous cell carcinoma and underwent surgery again. The scar was evaluated 6 months after surgery, and the scores of Vancouver scar scale and visual analogue scale were 2.42±1.04 and 7.83±1.21, respectively. The skin color of the operation area was similar to that of the surrounding skin without obvious local strain deformation.Conclusions:The subcutaneous pedicle flap designed by considering the nasal division and blood supply has a high survival rate, fewer complications and small local appearance deformation, which is worthy of popularization and application.

Clinical-neuroimaging-pathological relationship analysis of adult onset Neuronal Intranuclear Inclusion Disease (NIID).

BACKGROUND: Neuronal Intranuclear Inclusion Disease (NIID) is a degenerative disease with heterogeneous clinical manifestations. We aim to analysis the relationship between clinical manifestations, neuroimaging and skin pathology in a Chinese NIID cohort. METHODS: Patients were recruited from a Chinese cohort. Detail clinical information were collected. Visual rating scale was used for evaluation of neuroimaging. The relationship between clinical presentations and neuroimaging, as well as skin pathology was statistically analyzed. RESULTS: Thirty-two patients were recruited. The average onset age was 54.3 y/o. 28.1% had positive family history. Dementia, autonomic nervous system dysfunction, episodic attacks were three main presentations. CSF analysis including Aß42 and tau level was almost normal. The most frequently involved on MRI was periventricular white matter (100%), frontal subcortical and deep white matter (96.6%), corpus callosum (93.1%) and external capsule (72.4%). Corticomedullary junction DWI high intensity was found in 87.1% patients. Frontal and external capsule DWI high intensity connected to form a "kite-like" specific image. Severity of dementia was significantly related to leukoencephalopathy (r = 0.465, p = 0.0254), but not cortical atrophy and ventricular enlargement. Grey matter lesions were significantly associated with encephalopathy like attacks (p = 0.00077) but not stroke like attacks. The density of intranuclear inclusions in skin biopsy was not associated with disease duration, severity of leukoencephalopathy and dementia. CONCLUSIONS: Specific distribution of leukoencephalopathy and DWI high intensity were indicative. Leukoencephalopathy and subcortical mechanism were critical in pathogenesis of NIID. Irrelevant of inclusion density and clinical map suggested the direct pathogenic factor need further investigation.

Mid-Term Results of the First Dorsal Metacarpal Artery Flap for Thumb Defects.

Background: The thumb plays an important role in the function of the hand. Sensate reconstruction of the pulp is important in restoring function to the thumb. The aim of this study is to present outcomes of a sensate islanded first dorsal metacarpal artery (FDMA) flap used for the reconstruction of skin defects of the thumb. Methods: Patients who had a FDMA flap reconstruction of thumb pulp defects in the orthopaedics and traumatology clinic of affiliated hospital were included in the study. This included eight thumbs of eight patients. The range of motion, sensation and cosmetic satisfaction in the donor and recipient areas were evaluated at a minimum of 2-year follow-up. Results: There were no partial or complete flap failures. The mean static 2-point discrimination was 15 mm and the mean Semmes-Weinstein monofilament test score was 3.93. Cortical re-orientation was observed in 65% of patients. Near normal range of motion and Kapandji scores were regained in all patients. Conclusions: Excellent motion and sensory outcomes were obtained following the FDMA flap reconstruction of thumb pulp defects. The donor morbidity of the flap is minimal, and this flap can be considered as one of the primary options for reconstruction of thumb pulp defects. Level of Evidence: Level V (Therapeutic).