Omokawa S, Yajima H, Inada Y, Fukui A, Tamai S
Department of Orthopedics at Ishinkai-Yao General Hospital, Osaka, Japan.
Plast Reconstr Surg. 2000 Sep;106(4):828-33. doi: 10.1097/00006534-200009040-00012.
A reverse-flow island flap from the hypothenar eminence of the hand was applied in 11 patients to treat palmar skin defects, amputation injuries, or flexion contractures of the little finger. There were three female and eight male patients, and their ages at the time of surgery averaged 46 years. A 3 x 1.5 to 5 X 2 cm fasciocutaneous flap from the ulnar aspect of the hypothenar eminence, which was located over the abductor digiti minimi muscle, was designed and transferred in a retrograde fashion to cover the skin and soft-tissue defects of the little finger. The flap was based on the ulnar palmar digital artery of the little finger and in three patients was sensated by the dorsal branch of the ulnar nerve or by branches of the ulnar palmar digital nerve of the little finger. Follow-up periods averaged 42 months. The postoperative course was uneventful for all patients, and all of the flaps survived without complications. The donor site was closed primarily in all cases, and no patient complained of significant donor-site problems. Satisfactory sensory reinnervation was achieved in patients who underwent sensory flap transfer, as indicated by 5 mm of moving two-point discrimination. A reverse island flap from the hypothenar eminence is easily elevated, contains durable fasciocutaneous structures, and has a good color and texture match to the finger pulp. This flap is a good alternative for reconstruction of palmar skin and soft-tissue defects of the little finger.
应用来自手掌小鱼际隆起的逆行岛状皮瓣治疗11例患者的手掌皮肤缺损、截肢伤或小指屈曲挛缩。其中女性3例，男性8例，手术时平均年龄46岁。设计并逆行转移一块位于小指展肌上方、小鱼际隆起尺侧的3×1.5至5×2厘米的筋膜皮瓣，以覆盖小指的皮肤和软组织缺损。该皮瓣以小指尺侧掌指动脉为蒂，3例患者的皮瓣由尺神经背支或小指尺侧掌指神经分支提供感觉。随访期平均42个月。所有患者术后过程均顺利，所有皮瓣均存活且无并发症。所有病例供区均一期缝合，无患者主诉供区有明显问题。接受感觉皮瓣转移的患者获得了满意的感觉再支配，两点辨别觉移动5毫米可证明这一点。来自小鱼际隆起的逆行岛状皮瓣易于掀起，包含持久的筋膜皮肤结构，与指腹颜色和质地匹配良好。该皮瓣是修复小指掌侧皮肤和软组织缺损的良好选择。
