First dorsal metacarpal artery flap with dorsal digital nerve with or without dorsal branch of the proper digital nerve produces comparable short-term sensory outcomes.
First dorsal metacarpal artery flap with dorsal digital nerve with or without dorsal branch of the proper digital nerve produces comparable short-term sensory outcomes.
复制标题
第一掌背动脉 fap 与指背神经（带或不带适当指神经的背支）产生可比较的短期感觉结果
DOI：
10.1186/s13018-021-02838-z
复制
发表时间：
2021-11-18
影响因子：
2.6
通讯作者：
Xu W
中科院分区：
文献类型：
--
作者：
Feng SM;Zhao JJ;Migliorini F;Maffulli N;Xu W
带或不带指固有神经背侧支的第一掌背动脉皮瓣修复拇指指腹缺损效果良好。然而，目前还不清楚是否有保留或不保留指固有神经背侧支之间的感觉结果的差异。这项回顾性队列研究纳入了2015年10月至2019年6月期间接受第一掌背动脉皮瓣重建手术的137例拇指指腹缺损患者。根据是否保留指固有神经背侧支分为两组。不保留指背神经组（n = 80），将指背神经纳入皮瓣内重建感觉。保留指背神经及示指掌侧固有神经背侧支的皮瓣57例。缺损区指固有神经残端与皮瓣供神经端端吻合。在末次随访时，比较两组的静态两点辨别力、Semmes-Weinstein单丝评分、疼痛、再造手指的耐寒能力和患者满意度。所有患者均随访至少17个月。在拇指指腹疼痛、静态两点辨别力、Semmes-Weinstein单丝评分、受伤手指的冷耐受性和患者满意度方面没有发现显著差异。非保留组的手术时间略短（p < 0.05）。无论在第一掌背动脉皮瓣中是否保留固有指神经的背侧支，使用指背神经重建皮瓣感觉时，术后2年的临床结局无差异。证据等级：III级，回顾性比较研究。
The first dorsal metacarpal artery flap, including dorsal digital nerves with or without dorsal branches of the proper digital nerves, can be used to reconstruct thumb pulp defects with good results. However, it is still unclear whether there are differences in the sensory outcomes between preserving or not preserving the dorsal branches of the proper digital nerves. This retrospective cohort study included 137 thumb pulp defect patients who underwent first dorsal metacarpal artery flap reconstruction procedure from October 2015 to June 2019. Patients were divided into two groups according to whether the dorsal branches of the proper digital nerves were preserved. In the non-preservation group (n = 80), the dorsal digital nerves were included in the flap for sensory reconstruction. In the preservation group (n = 57), the dorsal digital nerves and the dorsal branches of the proper digital nerves of the index finger were included in the flap. The stump of the proper digital nerves in the defect was coaptated to the donor nerves of the flap using the end-to-end fashion. At the last follow-up, static two-point discrimination, Semmes–Weinstein monofilament scores, pain, cold intolerance of the reconstructed finger, and patient satisfaction in both groups were compared. All patients were followed up for at least 17 months. No significant differences were found regarding pain of thumb pulp, static two-point discrimination, Semmes–Weinstein monofilament score, cold intolerance in the injured finger, and patient satisfaction. The non-preservation group presented slightly shorter operative times (p < 0.05). There are no differences at 2 years in postoperative clinical outcomes when dorsal digital nerves are used to reconstruct flap sensation regardless of preservation of the dorsal branches of the proper digital nerves in the first dorsal metacarpal artery flap. Level of evidence: Level III, retrospective comparative study.
登录
查看更多内容
影响因子：
1.9
作者：
Chen, Chao;Zhang, Xu;Liu, Dequn
通讯作者：
Liu, Dequn
影响因子：
1.8
作者：
Wang, Hui;Chen, Chao;Wang, Zhiqiang
通讯作者：
Wang, Zhiqiang
影响因子：
1.5
作者：
Delikonstantinou, Iraklis P;Gravvanis, Andreas I;Tsoutsos, Dimosthenis A
通讯作者：
Tsoutsos, Dimosthenis A
影响因子：
3.6
作者：
Kimata, Y;Uchiyama, K;Harii, K
通讯作者：
Harii, K
DOI：
10.1016/j.bjps.2003.10.010
发表时间：
2004-01-01
期刊：
BRITISH JOURNAL OF PLASTIC SURGERY
影响因子：
--
作者：
Keramidas, E;Rodopoulou, S;Ioannovich, J
通讯作者：
Ioannovich, J