Chen S L, Chou T D, Chen S G, Cheng T Y, Chen T M, Wang H J
Division of Plastic and Reconstructive Surgery, Tri-Service General Hospital, Taipei, Taiwan, ROC.
Plast Reconstr Surg. 2000 Sep;106(4):834-9. doi: 10.1097/00006534-200009040-00013.
Finding an appropriate soft-tissue grafting material to close a wound located over the dorsum of a finger, especially the distal phalanx, can be a difficult task. The boomerang flap mobilized from the dorsum of the proximal phalanx of an adjacent digit can be useful when applied as an island pedicle skin flap. The vascular supply to the skin flap is derived from the retrograde perfusion of the dorsal digital artery. Mobilization and lengthening of the vascular pedicle are achieved by dividing the distal end of the dorsal metacarpal artery at the bifurcation and incorporating two adjacent dorsal digital arteries into one. The boomerang flap was used in seven individuals with injuries involving the dorsal aspect of the distal phalanx over the past year. Skin defects in all patients were combined with bone,joint, or tendon exposure. The authors found that the flap was reliable and technically simple to design and execute. This one-step procedure preserves the proper palmar digital artery to the fingertip and has proven valuable for the coverage of wide and distal defects because it has the advantages of an extended skin paddle and a lengthened vascular pedicle. When conventional local flaps are inadequate, the boomerang flap should be considered for its reliability and low associated morbidity.
找到一种合适的软组织移植材料来闭合位于手指背侧，尤其是末节指骨上的伤口，可能是一项艰巨的任务。从相邻手指近节指骨背侧掀起的双叶皮瓣作为岛状蒂皮瓣应用时可能会很有用。皮瓣的血供来源于指背动脉的逆行灌注。通过在分叉处切断掌背动脉远端并将两条相邻的指背动脉合并为一条来实现血管蒂的游离和延长。在过去一年中，双叶皮瓣被用于7例涉及末节指骨背侧损伤的患者。所有患者的皮肤缺损均伴有骨、关节或肌腱外露。作者发现该皮瓣可靠，设计和实施技术简单。这一步骤保留了至指尖的正常指掌侧固有动脉，并且由于其具有延长的皮瓣和延长的血管蒂，已被证明对覆盖广泛和远端缺损很有价值。当传统的局部皮瓣不足时，应考虑双叶皮瓣，因其可靠性和低相关发病率。
