A comparative study of two kinds of reverse radial flap for thumb soft tissue reconstruction / 中华显微外科杂志

ABSTRACT

Objective To evaluate the clinical results of the thumb dorsoradial flap and the greater thenar flap for coverage of thumb soft tissue defect,and to provide guidance on clinical selection of flaps.Methods From January,2013 to June,2014,23 thumb dorsoradial flaps and 20 greater thenar flaps were used to repair the soft tissues defects in thumbs and were followed up to compare the results.Patient satisfaction,cold intolerance scores,TAM of the reconstructed thumb,sensation (pain and temperature sensation,Semmes-Weinstein monofilament test,static two-point discrimination) and blood perfusion of the flaps were recorded and analyzed statistically.Results Thumb dorsoradial flaps group:patient satisfaction was (36.97 ± 7.70)％,cold intolerance score was 58.96 ± 12.47,TAM of the thumb was (87.57 ± 12.83)°,median Semmes-Weinstein monofilament test was 3.61mm,static two-point discrimination was (14.22 ± 2.84)mm,and blood perfusion was (98.41 ± 15.66) PU.Greater thenar flaps group:patient satisfaction was (50.00 ± 10.80)％,cold intolerance score was 60.45 ± 14.10,TAM of the thumb was (95.00 ± 14.58)°,median Semmes-Weinstein monofilament test was 4.31mm,static twopoint discrimination was (20.70 ± 2.56)mm,and blood perfusion was (104.74 ± 14.12)PU.The greater thenar flap had a larger degree of satisfaction than the dorsoradial flap (P ＜ 0.05).Both pain and temperature sensation of the flap were regained in all cases,but the dorsoradial flap presented better Semmes-Weinstein monofilament score and static two-point discrimination(P ＜ 0.05).No differences were found regarding TAM of the thumb,cold intolerance score and blood perfusion of the flap (P ＞ 0.05).Conclusion The dorsoradial flap is suitable for repairing the thumb pulp defect due to its good sensation.For the small defect of non-functional dorsal area,the greater thenar flap will be a satisfactory method.