Therapeutic effect of micro-flap carrying sensory nerve in treatment of high-pressure injection injuries of the digit
10.3760/cma.j.cn441206-20241209-00272
- VernacularTitle:携带感觉神经的微型皮瓣治疗手指高压注射伤的疗效分析
- Author:
Bo WEN
1
;
Gaofeng LIANG
1
;
Zenghui WANG
1
;
Manying ZHANG
1
;
Chaopeng DUAN
1
;
Jintong LIU
1
;
Zonghai JIA
1
;
Zhongyu JIA
1
Author Information
1. 兵器工业总医院手外一科，西安 710000
- Publication Type:Journal Article
- Keywords:
High-pressure injection injuries of the digit;
Sensory nerve;
Micro-flap;
Microsurgical technique
- From:
Chinese Journal of Microsurgery
2025;48(5):500-504
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the therapeutic effect of micro-flaps carrying sensory nerve in treatment of high-pressure injection injuries of the digit (HPIID).Methods:From January 2022 to June 2024, retrospective analysis of 7 patients who had HPIID were admitted to the Department of Hand Surgery Division 1, Norinco General Hospital. The patients were 5 males and 2 females with ages from 25 to 59 years. The digital injuries were: 3 index fingers, 2 middle fingers and 2 thumbs. All patients received debridement under microscope in primary surgery, with the defects at 1.5 cm×2.4 cm - 2.5 cm×5.5 cm in size after debridement. In stage Ⅱ surgery, 5 patients received the treatment of free fibular great toe flap carrying peroneal nerve of the great toe, with the flap size at 1.8 cm× 2.0 cm - 2.7 cm×4.0 cm. Two patients received the treatment of transfer of free fibular medial plantar flap carrying medial plantar nerve, with flap size at 1.9 cm×2.6 cm - 4.5 cm×5.7 cm. Donor sites were directly sutured in 5 patients, and 2 patients received skin grafting. Five patients received postoperative follow-up at outpatient clinic, 1 patient via telephone interview and 1 via WeChat review.Results:All 7 flaps survived and all wounds had primary healing. All donor and recipient sites and skin grafting sites healed primarily. Postoperative follow-up lasted for 4 to 9 months, with an average of 6.4 months. All the affected digits had satisfactory appearance and function, except 1 which was slightly slimmer than the healthy side. Range of motion of the affected digits was evaluated according to total active movement (TAM): 5 were in excellent and 2 in good. Sensory recovery of the digits was evaluated according to the British Medical Research Council (BMRC): 1 digit was at S 2, 2 at S 3 and 4 at S 4. One patient had two-point discrimination (TPD) at 9.0-15.0 mm, 2 at 6.0-10.0 mm, and 4 at 3.0-6.0 mm. Conclusion:For HPIID with a defect, surgical treatment with transfer of micro-flap carrying sensory nerve should be a preferred treatment option.
