Clinical application of radial dorsal digital artery flap with part short thumb extensor tendon in repairing dorsal skin defects of the thumb
10.3760/cma.j.cn114453-20220110-00006
- VernacularTitle:带部分拇短伸肌腱的桡侧指背动脉皮瓣修复拇指背侧复合组织缺损
- Author:
Hao LU
1
;
Mingyu XUE
;
Li QIANG
;
Xiao ZHOU
Author Information
1. 苏州大学附属无锡市第九人民医院手外科，无锡 214062
- Keywords:
Surgical flaps;
Extensor tendon;
Radial dorsal digital artery flap;
Thumb;
Composite tissue defects
- From:
Chinese Journal of Plastic Surgery
2022;38(10):1134-1138
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effectiveness of radial dorsal digital artery flap with part short thumb extensor tendon in repairing dorsal skin defects of the thumb.Methods:The clinical data of patients with thumb wounds complicated with extensor tendon defect who were repaired with radial dorsal digital artery flap with part short thumb extensor tendon in the Department of Hand Surgery, Wuxi No.9 People's Hospital from August 2018 to August 2020 were analyzed retrospectively. After the operation, the shape and function of the thumb were followed up by testing the two-point discrimination of chimeric flap, the sensory function and the thumb opposition function. The function of the thumb was evaluated with the reference of the total active movement (TAM) of fingers of the Chinese Medical Association Hand Surgery Branch.Results:A total of 10 cases with soft tissue defect of thumb were treated, whose tendon defect ranged 1.0-1.7 cm in length. There were 6 males and 4 females, aged from 20 to 67 years (mean, 41 years). The left hand was involved in 6 cases and the right in 4 cases. Radial dorsal digital artery flap with part short thumb extensor tendon were used to reconstruct extensor tendon and wound with the size of 2.0 cm×1.5 cm-3.0 cm×2.5 cm. The size of flap harvest was 2.5 cm× 1.8 cm-3.5 cm× 3.0 cm, and the tendon was 2.0-3.4 cm in length. All flaps in 10 patients were survived with primary healing.All patients were followed-up from 6 to 12 months, with the average of 8 months. Flaps presented good appearance and color, pliability. The two-point discrimination of chimeric flap was 7-10 mm (mean, 9 mm), and the thumb opposition function was good. The flap sensory function reached S3. The interphalangeal joint flexion of thumb was 60°-90 °, and the thumb opposition function was good. According to the total active movement system, excellent result was achieved in 8 cases and good in 2 cases.Conclusions:Radial dorsal digital artery flap with part short thumb extensor tendon was an ideal clinical method for repair of dorsal skin defects of the thumb, which can repair skin and tendon defects in one stage. The operation is simple with reliable blood supply. This method could also restore the appearance and function of fingers.
