Proximal thumb dorsal transverse flap for tissue defects at thumb pulp and fingertip
10.3760/cma.j.cn115530-20210802-00363
- VernacularTitle:拇指近节背侧横行皮瓣修复拇指指腹和指端组织缺损的疗效分析
- Author:
Qichao LI
1
;
Genqun LI
;
Yiting HU
;
Guozeng LI
;
Huanning ZHANG
;
Chao GUO
;
Suping JIANG
;
Nannan XIA
Author Information
1. 任丘市人民医院骨科，河北省沧州市 062550
- Keywords:
Thumb;
Surgical flaps;
Reconstructive surgical procedures
- From:
Chinese Journal of Orthopaedic Trauma
2021;23(11):995-999
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To report our clinical efficacy of pedicled transplantation of proximal thumb dorsal transverse flap to repair tissue defects at thumb pulp and fingertip.Methods:From February 2010 to November 2020, 97 patients with tissue defects at thumb pulp and fingertip were treated by pedicled transplantation of proximal thumb dorsal transverse flap at Department of Orthopedics, People's Hospital of Renqiu. They were 55 men and 42 women, aged from 17 to 66 years (average, 41.3 years). Altogether 55 right and 42 left sides were affected. The size of soft tissue defects ranged from 2.8 cm×1.8 cm to 3.9 cm×2.8 cm. Postoperatively, flap survival, shape, color and sensory recovery at the recipient area were observed; wound healing, function and complications at the donor site were also observed.Results:All the 97 flaps survived and all the wounds healed at the first stage. Blisters appeared at the distal end of the flap in only 2 cases but subsided 7 days after operation with no special treatment and the flaps survived smoothly. All the skin grafts at the donor site survived uneventfully. The 97 patients were followed up for 6 to 26 months (average, 10.7 months). Their flaps were not swollen, finger abdomen was full, finger appearance satisfactory, and finger feeling recovered well. The two-point discrimination at the last follow-up ranged from 4 to 11 mm (average, 7.6 mm). By the trial criteria for assessment of upper limb function suggested by Hand Surgery Society of Chinese Medical Association, sensory function of the affected finger was assessed as S 4 in 21 cases and as S 3+ in 76 cases at the last follow-up. No scar contracture was observed at the donor site and no movement restriction at the interphalangeal joint. Conclusion:Proximal thumb dorsal transverse flap is a reliable choice for reconstruction of complex tissue defects at thumb pulp and fingertip because of the advantages of easy harvest, constant vascular anatomy, full appearance and good sensory function at the recipient site, and limited damage to the donor site.
