Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator.
Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator.
复制标题
基于背穿支的顺行蒂皮瓣修复指尖缺损
DOI：
10.1097/gox.0000000000000732
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发表时间：
2016-06
期刊：
影响因子：
--
通讯作者：
Tang M
中科院分区：
文献类型：
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作者：
Wei P;Chen W;Mei J;Ding M;Yu Y;Xi S;Zhou R;Tang M
本文的目的是介绍和评估应用中指骨背端正常指神经维管束背侧支为基础的顺行蒂皮瓣修复指端缺损的长期随访结果。2011年2月至2012年12月，31例患者采用基于中指骨背侧穿支的同指瓣重建指端缺损。缺陷尺寸从1.3 cm × 1.5 cm到2.4 cm × 3.0 cm不等。在手术中，皮瓣被设计在指骨中背区。蒂是由动脉、静脉和感觉神经组成的神经血管束；椎弓根旋转<90度。随访3 ~ 9个月，临床效果满意。患者和医生都认为这些皮瓣在美容方面是可以接受的。感觉恢复良好，两点辨别力为4.96±1.47 mm，指间关节活动范围恢复良好。以指神经维管束背侧支为基础的顺行岛状皮瓣是修复指端缺损的一种理想的美学重建方法。90度旋转岛状蒂皮瓣用途广泛，设计简单，成活率高。该技术简单，对供体部位损伤小，不牺牲指动脉和神经分支。在不影响指间关节活动的情况下，可获得可靠的血供来源和满意的感觉恢复。
The purposes of this article are to introduce and assess the results of a long-term follow-up of using anterograde pedicle flap based on the dorsal branches of proper digital neurovascular bundles from the dorsum of the middle phalanx for the fingertip defect. Between February 2011 and December 2012, 31 patients underwent reconstruction of fingertip defects using a homodigital flap based on the dorsal perforator in the middle phalanx. The defect size ranged from 1.3 cm × 1.5 cm to 2.4 cm × 3.0 cm. During surgery, the flap was designed on the dorsal middle phalangeal region. The pedicle was a neurovascular bundle consisting of an artery, vein, and sensory nerve; the rotation of pedicle was <90 degrees. The clinical results were satisfactory after 3 to 9 months of follow-up. The flaps were considered cosmetically acceptable by both patients and doctors. The sensory recovery was excellent, 2-point discrimination was 4.96 ± 1.47 mm, and the recovery of range of motion of the interphalangeal joints was very good. The anterograde island flap based on the dorsal branches of proper digital neurovascular bundles is an ideal aesthetic reconstruction method for fingertip defect. A 90-degree rotated island pedicle flap was very versatile, easy to design, and had good survival. This technique is simple with less damage to the donor site, without sacrificing the branch of the digital artery and nerve. The reliable source of blood supply and satisfactory recovery of sensation can be achieved without affecting the interphalangeal joint activity.