Multi-segment inverted Y-shaped vein transplantation using anterior lateral malleolar venous network for repair of amputated palm injury distal to superficial palmar arch.
10.7507/1002-1892.202503002
- Author:
Zhao ZHANG
1
;
Yanyan WANG
2
;
Fei GAO
1
;
Yuehai PAN
1
;
Heng HUANG
1
;
Chao LU
1
;
Guozhong WANG
1
;
Zhigang QU
1
;
Benjun BI
1
Author Information
1. Department of Hand and Foot Surgery, Affiliated Hospital of Qingdao University, Qingdao Shandong, 266000, P. R. China.
2. Department of Medical Oncology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao Shandong, 266000, P. R. China.
- Publication Type:Journal Article
- Keywords:
Anterior lateral malleolar venous network;
amputated palm injury;
inverted Y-shaped vein;
superficial palmar arch;
vascular grafting
- MeSH:
Humans;
Adult;
Male;
Female;
Hand Injuries/surgery*;
Middle Aged;
Plastic Surgery Procedures/methods*;
Veins/transplantation*;
Surgical Flaps/blood supply*;
Hand/surgery*;
Treatment Outcome;
Soft Tissue Injuries/surgery*
- From:
Chinese Journal of Reparative and Reconstructive Surgery
2025;39(5):628-632
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the effectiveness of multi-segment inverted Y-shaped vein transplantation using the anterior lateral malleolar venous network for repair of amputated palm injury distal to the superficial palmar arch.
METHODS:Between September 2018 and July 2023, 5 patients with amputated palm injury distal to the superficial palmar arch were treated. There were 3 males and 2 females with an average age of 35.4 years (range, 29-52 years). The time from injury to admission was 1-6 hours (mean, 3.2 hours). The multi-segment inverted Y-shaped vein transplantation in the anterior lateral malleolar venous network were used to repair the common and proper palmar digital arteries; the another anterior lateral malleolar venous network was used to repair the dorsal vein of the hand. The soft tissue defect of dorsal hand in 1 patient was repaired with the pedicled ilioinguinal flap, and the wound at the donor site was directly sutured. Postoperative treatment included anti-infection therapy, antispasmodic therapy, and thrombosis prevention measures.
RESULTS:The partial necrosis of the fingertip of the thumb occurred in 1 case, and the marginal necrosis of the abdominal flap after operation occurred in 1 case. The remaining fingers showed good blood supply with normal tension. The incision at donor site of the abdominal flap healed by first intention. All patients were followed up 8-41 months (median, 19 months). At last follow-up, the hand contour was satisfactory; the grasping function, opposition function, and proprioception recovered, and two-point discrimination ranged from 5 to 7 mm (mean, 6 mm). According to the upper extremity function evaluation criteria issued by Hand Surgery Society of the Chinese Medical Association, the functional outcomes were excellent in 3 cases, good in 1 case, and fair in 1 case.
CONCLUSION:The multi-segment inverted Y-shaped vein transplantation using the anterior lateral malleolar venous network for repairing defects in the common and proper palmar digital arteries distal to the superficial palmar arch offers advantages such as superficial location, flexible harvesting, and high compatibility. This technique has demonstrated favorable outcomes in complex transmetacarpal amputation reconstruction.
