指真动脉背侧支皮瓣修复手指软组织缺损的临床效果。

IF 1 4区 医学 Q3 ORTHOPEDICS Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-06-14 DOI:10.2340/jphs.v58.11967
Yong Zhang, Jupu Zhou, Jianzhong Qin
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引用次数: 0

摘要

同种指背支指动脉皮瓣是修复指端远端软组织缺损的理想选择。本研究旨在评价HDBPDAF修复手指各种软组织缺损的临床效果,包括拇指和多指缺损。回顾性研究2014年8月至2021年12月采用HDBPDAF治疗44例手指缺损的40例患者。缺损部位为指尖指髓(28例)、指髓(10例)、指背(6例),暴露骨、肌腱或神经。皮瓣的平均尺寸为1.9 × 3.9 cm。通过长期随访评估Semmes Weinstein单丝(SWM)测试、静态二点辨别(2-PD)、总主动运动(TAM)评分、平均臂、肩、手残疾(DASH)评分。42个襟翼完全安然无恙。由于指真动脉背支缺失,2个皮瓣出现部分坏死。未见明显瘢痕挛缩及关节受限。皮瓣SWM评分平均为4.11±0.4 g。皮瓣平均2-PD为8.9±0.9 mm。损伤指平均TAM为268.7±5.2°(对侧为283.2±6.4°,p < 0.05)。平均DASH评分为29.7±7.9。尽管背支缺失率较低,但HDBPDAF是修复手指各种远端软组织缺损的最佳和可靠的选择。
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Clinical effects of homodigital dorsal branch of the proper digital artery flap on repairing soft tissue defects of fingers.

Homodigital dorsal branch of proper digital artery flaps (HDBPDAF) have been proved to be an excellent alternative for repairing distal soft tissue defects of fingertip. This study was to evaluate the clinical effects of HDBPDAF on repairing various soft tissue defects of fingers, including thumb and multi-fingers defects. A retrospective study was conducted in 40 patients with 44 finger defects treated with HDBPDAF from August of 2014 to December of 2021. The defects were located on fingertip and finger pulp (n = 28), finger pulp (n = 10), and dorsum of fingers (n = 6) with bone, tendon or nerve exposed. The average size of the flaps was 1.9 × 3.9 cm. Semmes Weinstein monofilament (SWM) test, Static two-point discrimination (2-PD), Total active motion (TAM) scores, the mean Disabilities of the Arm, Shoulder, and Hand (DASH) score were evaluated through long-term follow-up. Forty-two flaps survived completely and uneventfully. Partial flap necrosis was observed in two flaps because of the absence of dorsal branch of proper digital artery. No visible scar contracture and joint limitation were noticed. The mean SWM score of flaps was 4.11 ± 0.4 g. The average 2-PD of the flaps was 8.9 ± 0.9 mm. The mean TAM of injured fingers was 268.7 ± 5.2° (contralateral side: 283.2 ± 6.4°, p < 0.05). The mean DASH score value was 29.7 ± 7.9. The HDBPDAF was an optimal and reliable alternative to repair various distal soft tissue defects of fingers, despite a lower absent rate of dorsal branch.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
108
审稿时长
6-12 weeks
期刊介绍: The purpose of the Journal of Plastic Surgery and Hand Surgery is to serve as an international forum for plastic surgery, hand surgery and related research. Interest is focused on original articles on basic research and clinical evaluation. The scope of the journal comprises: • Articles concerning operative methods and follow-up studies • Research articles on subjects related to plastic and hand surgery • Articles on cranio-maxillofacial surgery, including cleft lip and palate surgery. Extended issues are published occasionally, dealing with special topics such as microvascular surgery, craniofacial surgery, or burns. Supplements, usually doctoral theses, may also be published. The journal is published for the Acta Chirurgica Scandinavica society and sponsored by the Key Foundation, Sweden. The journal was previously published as Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery.
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