Clinical application of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery

Kun Wang, W. Lei, Jiang-hai Chen
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Abstract

Objective To explore the operative method and clinical efficacy of retrograde transfer of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery for repair of fingertip defect of the same finger. Methods From May 2014 to August 2016, 9 cases (9 fingers) of fingertip soft tissue defects were treated by retrograde transfer of dorsal proximal phalanx fasciocutaneous island flap with anastomosis of cutaneous branch of the digital artery. All the patients had bone exposure. The defect area ranged from 1.2 cm×1.3 cm to 1.7 cm×2.0 cm. Results All the flaps survived uneventfully with primary healing in the wounds. The postoperative follow-up period ranged from 8 to 14 months, with an average of 11 months. The function and appearance recovery of fingers were satisfactory. The fingertip flaps were full without bulky pedicle. The sensory function recovered well. The fingertip two-point discrimination was 5 to 8 mm. Conclusion The dorsal proximal phalanx fasciocutaneous island flaps with anastomosis of cutaneous branch of the digital artery have reliable blood supply without sacrificing the digital artery and little influence on the donor site. It is suitable for repairing fingertip defects with good appearance and sensory recovery. Key words: Finger injuries; Surgical flaps; Cutaneous branch of the digital artery; Fingertip defects
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指动脉皮支吻合指骨背侧近端筋膜皮瓣的临床应用
目的探讨吻合指动脉皮支的指背近端筋膜皮肤岛状皮瓣逆行移植修复同指指尖缺损的手术方法及临床疗效。方法2014年5月~ 2016年8月,采用指动脉皮支吻合指骨近端背侧皮瓣逆行移植治疗9例(9指)指端软组织缺损。所有患者均有骨暴露。缺陷面积从1.2 cm×1.3 cm到1.7 cm×2.0 cm不等。结果皮瓣全部成活,创面初步愈合。术后随访8 ~ 14个月,平均11个月。手指的功能和外观恢复令人满意。指瓣饱满,无粗大的蒂。感觉功能恢复良好。指尖两点辨别力为5 ~ 8mm。结论吻合指动脉皮支的指骨近端背侧筋膜皮肤岛状皮瓣供血可靠,不牺牲指动脉,对供区影响小。适用于指尖缺损的修复,外观和感官恢复良好。关键词:手指损伤;外科皮瓣;指动脉皮支;指尖的缺陷
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