Reconstruction of totally degloved fingers with a spiraled parallelogram medial arm free flap
10.3760/cma.j.issn.1009-4598.2016.02.005
- VernacularTitle:臂内侧平行四边形游离皮瓣修复手指完全套状撕脱伤
- Author:
Zhenglin CHI
1
;
Peng YANG
;
Dajiang SONG
Author Information
1. 325027,温州医科大学第二附属医院手外科
- Keywords:
Fingers;
Degloving injury;
Arm;
Surgical flaps
- From:
Chinese Journal of Plastic Surgery
2016;32(2):103-106
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the therapeutic results of completely degloved digital injury using a parallelogram free flap from the medial arm in a spiral fashion.Methods From January 2011 to June 2013,13 defects in 13 patients with non-replantable degloved digital injury were treated with a parallelogram free flap from the medial arm in a spiral fashion.The longitudinal axis of the flap was along the line from the axilla to the medial humeral epicondyle.The medial brachial cutaneous nerve of the arm was harvested for sensory restoration.The non-replantable degloved finger was reconstructed with the medial arm flap in a spiral fashion.The digital artery and dorsal veins were prepared as the recipient pedicle,and the medial brachial cutaneous nerve was sutured to the digital nerve stump.All the wounds at the donor sites were closed directly.Results The dimension of the flaps ranged from 5.0 cm × 2.0 cm to 7.5 cm × 4.0 cm.Excetp for one partial flap loss,all the other flaps survived uneventfully with conservative therapy.The static 2-point discrimination test varied from 6 to 13 mm.No linear scar contracture was recorded in these patients.All the patients were satisfied with the overall results.Conclusions Resurfacing the defect in a spiral fashion is a valuable and reliable technique for the reconstruction of complete finger degloved injuries.The medial arm flap is a good option for this procedure,with satisfactory functional recovery and good aesthetic restoration.
