The modified antegrade digital artery island flap for severely flexion contracture of the burned finger / 中华显微外科杂志

ABSTRACT

Objective To investigate the clinical outcomes of using modified antegrade digital artery island flap for the treatment of the severely flexion contracture of the burned finger.Methods Between August,2013 to August,2015,21 patients (21 fingers) with severely flexion contracture of the burned finger were hospitalized for treatment.According to the Stren classification standard for the interphalangeal joint flexion contracture,all the patients were rated as type Ⅲ.The volar soft-tissue defect with exposed tendons,nerves,vessels or bone ranged from 1.0 cm × 2.0 cm to 2.5 cm × 4.0 cm after scar relaxation.The artery and the nerve defect were 1.5 to 4.5 cm and 2.0 to 4.2 cm,respectively.The wound were reconstructed with the modified antegrade digital artery island flap.The dorsal branches of the proper digital nerve of the flap were anastomosised with the proper digital nerve of the wound.The flap donor site was resurfaced with full-thickness skin grafting from inner aspect of the forearm.All the cases were called back for postoperative follow-up.Results All the reconstructed fingers and flaps survived completely without vascular problems.The donor skin graft survived and wound healed by first intention.All the patients were followed up with 11.5 months (range,6-22 months).The finger appearance was satisfactory.The texture and color of flaps in all cases were good.There was no pigmentation and contraction relapse.The contracted fingers received no cold intolerance.At the final examination,the average values of static 2-point discrimination were 5.2 mm (range,4.3-6.5 mm) of the flap.In the series,based on the Michigan Hand Outcome Questionnaire,18 patients were strongly satisfied with the injured finger appearance and 3 patients satisfied with the appearance.Conclusion The modified antegrade digital artery island flap,which is easy to raise with large flap size and can result with the good finger appearance and function,is an ideal technique for reconstruction of the severe flexion contracture of the burned finger.