Reconstruction of palmar soft tissue defects of two adjacent fingers with bilobed perforator flap of medial foot artery
10.3760/cma.j.cn441206-20240201-00036
- VernacularTitle:足内侧动脉分叶穿支皮瓣修复两个相邻手指掌侧软组织缺损
- Author:
Shengquan REN
1
;
Zhenlu CAO
1
;
Zhengdan WANG
1
;
Caifeng WU
1
;
Chunlei LIU
1
;
Xiaoheng DING
1
Author Information
1. 青岛大学附属医院手足显微外科，青岛 266071
- Publication Type:Journal Article
- Keywords:
Perforator flap of medial foot artery;
Artificial dermis;
Digit;
Soft tissue defect;
Donor site
- From:
Chinese Journal of Microsurgery
2024;47(6):625-629
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effect of reconstruction of soft tissue defect on the palmar side of 2 adjacent fingers with bilobed perforator flap of medial foot artery.Methods:From September 2020 to September 2023, 6 patients with soft tissue defects on the palmar side of 2 adjacent fingers were treated in the Department of Hand and Foot Microsurgery, the Affiliated Hospital of Qingdao University. After admission, Doppler ultrasound scan was performed to locate the perforating branches of the deep and superficial branches of medial foot artery, as well as the course of medial foot artery. A bilobed flap with two perforating branches of medial foot artery was used to reconstruct the soft tissue defects on the palmar side of 2 adjacent fingers. The perforators of medial foot artery were anastomosed with the proper palmar digital arteries, and the accompanying veins was anastomosed with the dorsal digital veins. The branches of saphenous nerve were anastomosed with the proper palmar digital nerves. The sizes of soft tissue defect were 4.5 cm×2.0 cm-3.0 cm×1.5 cm, and the flaps sized 5.0 cm×2.5 cm-3.5 cm×2.0 cm. All donor sites for the perforator flaps were covered by artificial dermis (4 patients) or autologous skin grafts (2 patients). Short and long-term follow-up for flap survival, flap shape, scar, and functions of interphalangeal joint and metacarpophalangeal joint function were evaluated in outpatient clinic and WeChat reviews.Results:All the bilobed perforator flaps of medial foot artery survived in 6 patients. There was no infection in the flap and donor area. Wounds in fingers and dornor sites in foot all healed well. Postoperative follow-up ranged 4-12 months, with an average of 9.3 months. The sensation of the palmar fingers recovered well with TPD at 7-10 mm and at 8.5 mm in average. The sensation recoveries were up to S 3-S 4. According to the Evaluation Trial Standards of Upper Limb Partial Function of Hand Surgery of the Chinese Medical Association, 5 patients (10 fingers) were rated as excellent and 1 patient (2 fingers) as good. The donor sites healed well and walking, running, jumping, mountaineering and other food motions were not affected, and without any obvious discomfort. According to the American Orthopedic Foot and Ankle Societ (AOFAS) ankle-hindfoot score, the ankle functions of 6 patients were evaluated as excellent. Conclusion:A bilobed perforator flap of medial foot artery is applied to reconstruct the soft tissue defects on the palmar side of 2 adjacent fingers. It can simultaneously reconstruct 2 defects in a single surgery, and offer a fast functional recovery and aesthetical appearance.
