A reverse dorsal digital island fascial flap with the dorsal branch from the proper digital nerve for repair of pulp defects / 中华骨科杂志

ABSTRACT

Objective To utilize a reversed digital dorsal fascial vascular pedicled island fa scial flap with the dorsal branch of the proper d igital nerve to repair finger pulp defect.Methods Based on the features of blood supply of the dorsa l skin of the finger,the flap was designed on the proximal phalanx at the middle and distal segments and the dorsum of the proximal interphalangeal joint.The lateral margins of the fl ap did not cross the midlateral line,th e axial point was designed on the ulnar or the radial dorsum of the distal interphalangeal joint.The axis was paralleled to the longitudinal axis of finger.The dorsal branch of the pr oper digital nerve in the flap was sutured to the end of the proper digital nerve of injured site.From November 1997to April 2001,28pulp defects in 27cases were repaired with this method.E mergency operations were per-formed in 24cases and selective operations in 3.The flaps measured 1.8cm?1.5cm -2.5cm ?2.2cm and the length of pedicle was 1.5-2.2cm.Results All flaps survived completely.The p atients were followed up for 7to 32months,with an average o f 21months.The pulps after reconstr uction had good appearance,soft texture with wear-resisting.T here was no touch pain.Static two-point discrimination was 3.5-6.5mm.Conclusion The operation does not damage the major artery and nerve of the wounded fin ger.It is simple and safe,and can be done at one settin g.It does not interfere with the function of other digits.The sensation of the reconstructed pulp can be satisfactorily recovered.[