Innervated arterialised venous flap of the first dorsal metacarpal in reconstruction of thumb and finger pulp defect
10.3760/cma.j.cn441206-20230604-00097
- VernacularTitle:第1掌骨背侧带神经动脉化静脉皮瓣治疗拇指和手指指腹缺损
- Author:
Hang ZHANG
1
;
Yaping LIU
;
Linjun TANG
;
Fujun ZENG
;
Guohua JIANG
;
Yuchuan LIU
;
Jie DIAO
Author Information
1. 四川现代医院手外科，成都 610041
- Keywords:
Venous flap;
Arterialised;
Digit pulp defect;
Superficial branch of radial nerve;
Thumb;
Finger
- From:
Chinese Journal of Microsurgery
2023;46(5):511-515
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application and clinical efficacy of an innervated arterialised venous flap of the first dorsal metacarpal in reconstruction of thumb and finger pulp defects.Methods:From December 2021 to August 2022, 17 patients received surgery for reconstruction of thumb and finger pulp defects in the Department of Hand Surgery of Sichuan Modern Hospital. All were carried out in emergency surgery. The affected digits included: 3 thumbs, 4 index fingers, 6 middle fingers, 1 ring finger and 3 little fingers. After emergency debridement, a flap of the first dorsal metacarpal carrying superficial radial nerve and arterialised vein was taken for reconstruction of the defect. Donor site of the flap was directly closed with sutures. The survival and functional recovery of the digits and flaps were evaluated through postoperative follow-ups via outpatient visit and telephone and WeChat interviews.Results:Seven flaps developed blisters after surgery, which gradually subsided and healed after dressing change. The rest of 10 flaps survived smoothly, without any vascular compromise. All of the 17 patients(17 digits) had postoperative follow-up for 3-15 months, with 8 months in average. Appearance of thumb and finger pulps were good, with sensation restored to S 1-S 3+, according to the sensory function evaluation criteria of the British Medical Research Council(BMRC). According to Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, all 17 patientswere in excellent of total active movement(TAM). Conclusion:Innervated arterialised venous flap of the first dorsal metacarpal is reliable in reconstruction of the defects of digit pulps with good function and appearance. The flap is easy to take and with a satisfactory recovery of sensation.
