Repair of children fingertip defect with dorsal nerve fasciocutaneous flap / 局解手术学杂志

Objective To investigate the clinical curative effect of dorsal nerve fasciocutaneous flap in the treatment of children fingertip defect.Methods A total of 20 children (26 fingers)with fingertip defect were chosen as the research objects,and all of them were given the dorsal nerve fasciocutaneous flap surgery within the same finger.The sensory recovery,color,shape and function of the fingers were ob-served.Results All the 26 fingers were survived,and the survival rate was 100%.There were 8 cases of ambient blood circulation crisis 1 to 2 days after the surgery which were eliminated with corresponding treatment.Postoperative follow-up results showed that the sensory re-covery of the skin flap was S2 ~S3 6 months after surgery,and the two-point discrimination (2-PD)was 8 ~14 mm;the sensory recovery of the skin flap was S3 ~S3 +(19 fingers of S3 and 7 fingers of S3 +)12 months after surgery,and the two-point discrimination (2-PD)was 6 ~10 mm;the sensory recovery of the skin flap was S3 +~S4 (20 fingers of S3 +and 6 fingers of S4)12 months after surgery,and the two-point discrimination (2-PD)was 5 ~8 mm.Up to then,the finger shape and color of patients was similar with normal finger,the skin graft donor site was smooth without scar contracture,the finger joint function recovered well,and the distal interphalangeal joint function were normal.Conclusion Treatment of dorsal nerve fasciocutaneous flap repair for children fingertip defect has good clinical effect and it is wor-thy of clinical application.

Reconstructing finger hemiarthrosis injury with free second toe hemiarthrosis graft / 中华显微外科杂志

ObjectiveTo report the clinical results of applying free second toe hemiarthrosis to repair finger hemiarthrosis injury,and discussed the countermeasures of relative problems.MethodsFrom June 2005 to January 2010, thirteen fingers of 13 patients with traumatic finger joint injury had repaired by using vascularized second toe hemiarthrosis graft.ResultsAll 13 grafted fingers survived,and all wounds were primary healing.The time of follow-up was between 1.5 and 4.5 years,average of 3.2 years.All grafted joints were healed and the remaining joints were normal in morphology and structure,except for 1 patient subluxation with dorsal slightly convex.No degenerative changes happened to the grafted joints.No pain and no joint instability phenomenon.Nonunion and re-fracture phenomenon did not appear.The average extension of joint motion was 0°.The average flexion was 80°.Healing of the foot donate areas were satisfactory,and did not affect walking function.Using TAM assessment method of the hand joint function,the excellent rate was 90％.ConclusionThe way of using free second toe hemiarthrosis to repair finger hemiarthrosis injury could achieve satisfactory clinical efficacy.To completed set-up of transplanted joint structure and function units,a delicate surgery were improved to be important factors of the surgical treatment.

Application dorsalis pedis flap to repair the hands of series 2 of skin and soft tissue defect / 中华显微外科杂志

Objective To evaluate the clinical effects of free dorsalis pedis flap on the repair of two skin and soft tissue defects in hand. Methods From February 2003 to February 2009, free dorsalis pedis flap was used to repair two skin and soft tissue defects in 11 patients. Six cases were males and 5 females.Two was used the hand skin and soft tissue defects in 4 cases; back of the hand skin and soft tissue defect with the middle finger proximal palmar skin and soft tissue defect in 1 case, the hand ripped through injury to the back of the hand of the hand ripped through skin and soft tissue defects in 3 cases, were cut flap:proximal flap 3 cm× 3 cm-8 cm × 7 cm, distal flap 4 cm × 2 cm-6 cm × 5 cm. Foot for the area will adopt the lower abdominal full-thickness skin grafting. Results Uniform flap survival period of the wound healing class, foot skin graft donor sites were successfully survived. Ten patients were followed up from 6 to 19 months, with an average follow-up of 9 months. Follow-up flap fine texture, appearance of natural, nonbloated, feeling to restore S2-S3, hand function recovered satisfactorily, for the district of foot healed well without ulceration and ulcer formation,had no effect on walking function. Conclusion The dorsalis pedis flap for hand two series of skin and soft tissue defects, with design flexibility, excellent texture flaps, etc., is to repair the hand skin and soft tissue defects of the two better way.