ABSTRACT
Objective To investigate the treatment of outcomes of repairing soft tissue defects of the palmar finger accompanied by proper digital artery and nerve defects.Methods From January,2014 to June,2016,7 patients(4 males and 3 females.Patients'age ranged from 18 to 45 years,with an average of 28.5 years) with soft tissue defects on the palmar side of the proximal and middle phalanx of the fingers accompanied by proper digital artery and nerve defects were treated by first dorsal metatarsal artery Flow-through flap,application of color Doppler ultrasound was used in the detection of vascular type before operation.The flap area was from 2.0 cm×2.5 cm to 3.5 cm×5.5 cm.All the donor site of the flap were sutured directly.The patients were followed-up in 1 month,3 months,6 months,12 months,24 months after the surgery,and the results were evaluated according to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association.Results All flaps survived.These cases were followed-up for 6 to 24 months,average 12 months.All the flaps got satisfactory appearance and good sense function,and 2-PD of the flap averaged 7 mm,ranging from 6 mm to 12 mm.All injured fingers got satisfactory appearance and good sense function,2-PD of the injured fingers averaged 8 mm,ranging from 6 to 15 mm.The donor site incision healed well no obvious scar hyperplasia,good function.Conclusion Application of the first dorsal metatarsal artery Flow-through flap to reconstruct soft tissue defects of the palmar finger accompanied by proper digital artery and nerve defects,can achieve good clinical effects.This method can restore the appearance,blood supply and sensation of the injured finger.
ABSTRACT
Objective To discuss the treatment method and effect of the application of the dorsal branches island flaps of the digital arteries in clinic.Methods During January,2010 to February,2015,a total of 20 cases of palmar soft tissue defect of the 2nd-5th distal segments of single fingers were incorporated and repaired by the dorsal branches island flaps of the digital arteries in the base of the distal phalanx.The size of the selected flaps was 3.5 cm × 2.5 cm-2.0 cm × 2.0 cm.In addition,palmar soft tissue defect (n =15) of the 2nd-5th middle and distal segments of single fingers were repaired by the dorsal branches island flaps of the digital arteries at the 1/3 site of the proximal digital arteries,and the selected flaps size was 4.5 cm × 2.5 cm-3.0 cm × 2.0 cm.Full-thickness skin graft urethroplasty was used in the donor sites.Flap shape,texture,sensory recovery and texture of the skin region,function recovery of the wounded fingers were followed up at 1,3,and 6 months after operation.Results Thirty-five patients were followed up from 6 to 13 months (average of 7 months).All flaps survived completely in the incorporated 35 cases postoperatively.Flaps had satisfactory appearance,fine texture,and soft texture in the skin transplantation area.The postoperative improvement of sensory function was between S2 and S3,and the two-point discrimination was 10-15 mm.Assessment of the upper limb function using the standard issued by the Hand Surgery Society of Chinese Medical Association graded 23 cases as excellent,10 cases as good,and 2 cases as fair.Conclusion The dorsal branches island flaps of the digital arteries are characterized by easy dissection,reliable blood supply,and no major blood vessels needed to be sacrificed,which is an effective procedure for finger soft issue defect repairing.