Vasseur C, Legré R, Leps P, Schoofs M
Service de chirurgie plastique, CH Saint-Luc-Saint-Joseph, Lyon, France.
Chir Main. 2000 Feb;19(1):44-55. doi: 10.1016/s1297-3203(00)73459-7.
In case of a fingertip trauma, the surgeon'aim is to give the finger a good function, that means a fingertip with good sensibility and trophicity. The purpose of this study was to follow-up three different types of flaps used for fingertip reconstruction, and to analyse their sensibility and functional results.
62 fingertip-flaps performed in 60 patients were included in this series. Patients were mainly males (45-60), adults (42-60), middle age (mean age = 40), right-handed (55-60) and home-injured (32-60). The dominant side was injured more often (43-60), by section (27-60) or crush (25-60). Patients were reviewed by the same investigator. Various types of flaps were used: 31 Atasoy flaps, 19 neurovascular island unipedicled flaps and 12 Hueston flaps. Sensory results were evaluated using static and moving two-point discrimination tests, and pain and hot-cold discrimination. Esthetic and functional results were also evaluated.
The tactile sensibility was good or excellent in 63% of flaps and the nail looked good in 70% of flaps. Among all flaps, the Atasoy flap obtained the best results.
This study showed the good quality of Atasoy and Hueston flaps in fingertip reconstruction. Neurovascular island flaps gave poor results without taking in account the severity of initial trauma.
在指尖创伤的情况下，外科医生的目标是赋予手指良好的功能，即拥有良好感觉和营养状态的指尖。本研究的目的是对用于指尖重建的三种不同类型皮瓣进行随访，并分析它们的感觉和功能结果。
本系列纳入了60例患者所做的62例指尖皮瓣手术。患者主要为男性（45 - 60岁）、成年人（42 - 60岁）、中年（平均年龄 = 40岁）、右利手（55 - 60例）且受伤地点为家中（32 - 60例）。优势侧受伤更为常见（43 - 60例），损伤类型为切割伤（27 - 60例）或挤压伤（25 - 60例）。由同一位研究者对患者进行复查。使用了各种类型的皮瓣：31例阿塔索伊皮瓣、19例神经血管岛状单蒂皮瓣和12例休斯顿皮瓣。使用静态和动态两点辨别试验、疼痛及冷热辨别来评估感觉结果。同时也评估了美观和功能结果。
63%的皮瓣触觉感觉良好或极佳，70%的皮瓣指甲外观良好。在所有皮瓣中，阿塔索伊皮瓣取得了最佳结果。
本研究显示了阿塔索伊皮瓣和休斯顿皮瓣在指尖重建中的良好质量。神经血管岛状皮瓣在未考虑初始创伤严重程度的情况下效果较差。
