Free Lateral Digital Flap for Reconstruction of the Fingers
Free Lateral Digital Flap for Reconstruction of the Fingers
复制标题
用于手指重建的免费横向指状皮瓣
DOI：
10.1097/sap.0000000000001090
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发表时间：
2017
影响因子：
1.5
通讯作者：
Takafumi Saito
中科院分区：
文献类型：
--
作者：
H. Yoshimatsu;T. Iida;A. Hayashi;Takafumi Saito
背景近端指间关节（PIP）和掌指关节（MP）折痕之间的区域比手指其他区域具有更大的松弛度，允许供区的一期闭合。我们假设，如果我们能够始终定位从PIP和MP折痕之间的区域的穿支在中指和环指的桡侧，其上的疤痕将不太明显，比一个在食指的桡侧，这些地区将是理想的供体部位的数字重建使用非常小的皮瓣。方法5例志愿者20指（中指10指，环指10指），应用超声显像技术，在PIP与MP皱襞之间显示桡侧指固有动脉穿支。在此基础上，为了评价其可行性，我们应用游离指侧方皮瓣修复了3例手指小缺损。结果20个手指中，19个手指在PIP和MP折痕之间至少有1个指动脉穿支（DAP）起源于桡侧指固有动脉。PIP折痕至DAP的平均距离为9.0 mm，DAP的平均直径为0.37 mm。无供体部位并发症。结论中指或环指桡侧游离指侧方皮瓣解剖结构一致，供区并发症相对较低，是修复手指掌侧缺损的可靠选择。
Background The region between the proximal interphalangeal (PIP) and the metacarpophalangeal (MP) creases has greater laxity than other regions in the fingers, allowing for primary closure of the donor site. We postulated if we could consistently locate perforators from the region between the PIP and the MP crease on the radial side of the middle and ring fingers, on which a scar would be less conspicuous than one on the radial side of the index finger, these regions would be ideal donor sites for digital reconstruction using very small flaps. Methods In 20 fingers (10 middle fingers and 10 ring fingers) from 5 volunteers, perforators from the radial proper digital artery were visualized between the PIP and the MP creases using ultrasonography. Based on this information, and to evaluate its feasibility, a free lateral digital flap was used for reconstruction of small digital defects in 3 cases. Results Of the 20 fingers, 19 had at least 1 digital artery perforator (DAP) arising from the radial proper digital artery between the PIP and MP creases. The average distance from the PIP crease to the DAP was 9.0 mm. The average diameter of the DAP was 0.37 mm. In all clinical cases, flaps survived completely with pleasing cosmesis. There were no donor site complications. Conclusions With their consistent anatomy and relatively low donor site morbidity, free lateral digital flaps from the radial side of the middle or ring fingers may be a reliable option for reconstruction of the volar surface of the digits.