Efficacy of reconstruction of thumb skin defect with dorsal index finger flap pedicled with radial digital proper artery
10.3760/cma.j.issn.1001-8050.2018.04.011
- VernacularTitle:附加桡侧指动脉为血管蒂示指背侧皮瓣修复拇指皮肤缺损的疗效
- Author:
Zenggang CHEN
1
;
Ming LI
;
Yuanjun FAN
Author Information
1. 401320重庆,重庆市巴南区人民医院骨科,手外科
- Keywords:
Hand injuries;
Surgical flaps;
Thumb
- From:
Chinese Journal of Trauma
2018;34(4):351-356
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of dorsal index finger flap pedicled with radial digital proper artery for reconstruction of thumb skin defect.Methods A retrospective case series study was conducted on the clinical data of 78 patients with thumb skin defect admitted from August 2009 through September 2015.According to the treatment method,the patients were divided into Group A which adopted dorsal index finger flap pedicled with radial digital proper artery and Group B which adopted the conventional dorsal index finger flap for the reconstruction of thumb skin defect.Group A (n =47) comprised of 31 males and 16 females,aged averagely 29.6 years (range,20-54 years),and Group B (n =31) comprised of 22 males and nine females,aged averagely 27.3 years (range,19-55 years).The dimensions of skin defect were (9.02 ±0.45)cm2 in Group A and (7.15 ±0.72)cm2 in Group B.The cut flap area,operation time,postoperative visual analogue score (VAS),flap survival rate,two point discrimination recovery,and evaluation criteria of the upper limb function of the Chinese Medical Association (joint activity,shape,muscle strength,sensory recovery,sequelae,and work ability) were compared between Groups A and B.Results The cut flap area was (9.25 ± 0.78) cm2 in Group A and (7.25 ± 0.61) cm2 in Group B (P ＜ 0.05).The operation time was (1.75 ± 0.36) hours in Group A,and (1.64 ± 0.29) hours in Group B (P ＞ 0.05).The VAS was (7.40 ± 0.36) points in Group A,and (6.33 ± 0.47) in Group B (P ＞ 0.05).All flaps of Group A survived without any epidermal necrosis or bister,with the survival rate of 100％;while four cases of Group B had partial or total necrosis,with the survival rate of 87％ (P ＜ 0.05).The two point discrimination was (6.33 ± 1.41) mm in Group A,and (8.80 ± 1.43)mm in Group B (P ＜ 0.05).According to the evaluation criteria of the upper limb function of the Chinese Medical Association,the results of Group A were excellent in 21 cases,good in 22,and poor in four,with the excellent and good rate of 92％;while the results of Group B were excellent in 14 cases,good in 8,poor in 5,and worst in 4,with the excellent and good rate of 71％ (P ＜ 0.05).Conclusion Dorsal index finger flap pedicled with radial digital proper artery for the reconstruction of thumb skin defect is worthy of clinical practices,for the advantages of larger cut flap area,improved flap survival rate and quality,and better recovery of upper limb function.
