Clinical effect of free flap from superficial palmar branch of the radial artery for repairing compound tissue defect of finger dorsum
10.3760/cma.j.cn114453-20210329-00140
- VernacularTitle:桡动脉掌浅支腕横纹游离皮瓣修复指背复合组织缺损的临床治疗效果
- Author:
Song ZHANG
1
;
Yao WU
;
Ziqiang DONG
;
Buguo CHEN
Author Information
1. 徐州仁慈医院手外科，徐州 221004
- Keywords:
Microsurgery;
Surgical flaps;
Superficial palmar branch of the radial artery;
Repair
- From:
Chinese Journal of Plastic Surgery
2022;38(12):1344-1349
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of free wrist crease flap based on the superficial palmar branch of radial artery in the treatment of compound tissue defect of dorsal finger.Methods:From January 2015 to June 2019, the clinical data of patients admitted to the Department of Hand Surgery, Xuzhou Renci Hospital with skin, soft tissue and tendon defects of dorsal fingers, with or without bone exposure, were retrospectively analyzed. The free wrist crease flap based on the superficial palmar branch of radial artery was used. For patients with dorsal finger wounds less than 2.5 cm in length, palmaris longus tendon was used in the flap to repair, and the direction of flap incision and dorsal finger repair was consistent. If the length of dorsal finger defect was more than 2.5 cm, the palmaris longus tendon was not carried in the flap. The wrist crease flap based on the superficial palmar branch of the radial artery was harvested, and the free palmaris longus tendon was used to repair the defect along the same incision. The flap was selected according to the left and right wrist donor site flap and rotated 90° counterclockwise or clockwise to cover the dorsal finger wound. The flap survival and texture were followed up after operation. The total active movement(TAM) of fingers was evaluated according to the trial standard for the evaluation of the upper limb function of the Hand Surgery Society of the Chinese Medical Association.Results:A total of 17 patients were enrolled in this study, including 12 males and 5 females. The mean age was 39.5 years (range, 21-65 years). There were 10 cases of left finger and 7 cases of right finger. The area of dorsal finger skin defects ranged from 1.5 cm×1.3 cm to 3.8 cm×2.0 cm, and the area of flap ranged from 1.8 cm×1.5 cm to 4.0 cm×2.2 cm. The patients were followed up for 3 to 48 months, with an average of 16.5 months. All the flaps survived and healed well. The texture of the flap was good, and no obvious swelling was observed. Venous crisis occurred in 1 case 18 hours after operation. The stitches were removed, the edge of the flap was bled, and the flap survived after 10 days. All wrist donor sites were sutured directly and healed well after operation. There was no abnormality in wrist flexion and extension function. The TAM of fingers was rated as excellent in 12 cases, good in 4 cases, and fair in 1 case.Conclusions:The free wrist crease flap based on the superficial palmar branch of radial artery is an alternative method for repairing compound tissue defect of dorsal finger. The recipient flap has no bloated appearance. Finger extension function could be reconstructed. The wound at the donor site is small and could be closed directly.
