ABSTRACT
Objective:To explore the clinical effects in repairing dorsal complex tissue defect of finger with the flap based on superficial palmar branch of radial artery (SPBRA) with palmaris longus tendon.Methods:From May, 2011 to October, 2017, dorsal complex tissue defects of 15 fingers and thumbs in 15 patients were treated by the flaps which were based on SPBRA with palmaris longus tendon. There were 10 males and 5 females, in an average of 35.8 (19-51) years. All the defects (3 thumbs, 5 index, 2 middle and 5 ring fingers) were dorsal complex tissue defects and all had extensor tendon defects. The areas of soft tissue defect measured 2.0 cm×1.5 cm to 4.0 cm×2.0 cm. The lengths of tendon defect measured 2.0-4.0 cm. All patients received emergency surgery. The time before the surgery was 1.5-3.0 hours. The surgery time was 3.0-4.5 hours, 3.6 hours in an average. Postoperative regular follow-up.Results:All of the wounds healed in stage I and all flaps survived. Texture of the flaps was soft with rosy color. No obvious swelling occurred. All the donor sites healed in stage I. The patients were followed-up for 4-18 months, 8 months in an average. The appearance and function of the repaired fingers and thumbs were satisfactory. The pain, temperature and touch sensations were good. The color of flaps was similar to the normal finger without swelling. The wear resistance of the flaps was good. Thin-line scars were in the wrist donor sites without contracture. The range of motion of active palmar flexion of the wrist was from 0° to 80° and active hyperextension was from 0° to 70°. No obvious limitation was found.Conclusion:It is able to achieve a satisfactory clinical effects by using the flap that is based on SPBRA with palmaris longus tendon in repairing the dorsal complex tissue defect of hand. The advantages of the technique are that the donor site is concealed. The wound is small, and the flap is easy to be harvested and anastomosed.
ABSTRACT
Objective To investigate the clinical effect of super large venous flap with palmaris longus tendon for repairing the complex tissue defect of the palm of finger.Methods From May,2011 to October,2017,complex tissue defect of the palm of 15 fingers in 15 cases was treated by a super large vein flap with palmaris longus tendon.There were 10 males with 10 fingers and 5 females with 5 fingers.The age was from 19 years to 51 years (average,35.8years).Among these cases,machine injury was in 12 cases and crush injury was in 3 cases.Complex tissue defect of the palm of the finger with tendon defect occurred in all the cases.There were 3 thumbs,5 index fingers,3 middle fingers and 5 ring fingers.The area of skin defect was from 3.5 cm×2.0 cm to 7.5 cm×3.5 cm.The length of tendon defect was 2.0-4.0 cm.Phalangeal fractures occurred in 4 cases (2 cases of proximal phalanx,1 of middle phalanx,and 1 of distal phalanx).All the patients received the operation in one stage.The time between the injury and the operation was 1.5-3.0h(average,2.0 h).The time of the operation was 3.0-4.5 h(average,3.6 h).Regular followed-up was performed after operation.Results All flaps survived.Fourteen cases were followed-up for 6 to 12 months(average,7 months),and 1 case lost.The skin flap has soft texture,good elasticity,and no bloat.The color of skin flap was close to the normal skin.Sensory recovery reached S2 to S3,and the function and appearance of the finger were well restored.Conclusion The super large vein flap with palmaris longus tendon can be used to repair the complex tissue defect of the palm of fingers.The flap can get a satisfactory effect after surviving.It is an ideal method of repairing this kind of damage.