Delikonstantinou Iraklis P, Gravvanis Andreas I, Dimitriou Vasilios, Zogogiannis Ioannis, Douma Amalia, Tsoutsos Dimosthenis A
Department of Plastic Surgery, General State Hospital of Athens, Athens, Greece.
Ann Plast Surg. 2011 Aug;67(2):119-22. doi: 10.1097/SAP.0b013e3181ef6f6d.
Our study aims to illustrate the advantages and disadvantages of Foucher's first dorsal metacarpal artery flap and Littler's heterodigital neurovascular flap in thumb pulp reconstruction, by assessing wound healing of donor and recipient sites, sensibility, and functional outcome of the reconstructed thumb. Fourteen male patients were reconstructed either with Foucher (n = 8) or Littler flap (n = 6). Dissection of Foucher's flap was faster than that of Littler's flap. All Littler flaps survived completely, but we experienced 1 partial Foucher flap necrosis. Thumb motility and stability was optimal in all patients. Wound healing of donor sites was achieved in both groups. Two patients reconstructed with Littler flap developed scar contractures and presented a reduced range of motion of donor finger and first webspace, respectively. Although Littler flap resulted in better sensibility and tactile gnosis of the reconstructed thumb-pulp, Foucher flap ensured negligible donor site morbidity, complete cortical reorientation, and better overall hand function.
我们的研究旨在通过评估供区和受区伤口愈合情况、感觉以及重建拇指的功能结果，阐明福谢（Foucher）第一掌背动脉皮瓣和利特勒（Littler）异体手指神经血管皮瓣在拇指指腹重建中的优缺点。14例男性患者分别采用福谢皮瓣（n = 8）或利特勒皮瓣（n = 6）进行重建。福谢皮瓣的解剖速度比利特勒皮瓣快。所有利特勒皮瓣均完全存活，但我们有1例福谢皮瓣部分坏死。所有患者的拇指活动度和稳定性均最佳。两组供区伤口均愈合。2例采用利特勒皮瓣重建的患者出现了瘢痕挛缩，分别表现为供指和第一掌指关节间隙活动范围减小。尽管利特勒皮瓣使重建的拇指指腹感觉和触觉辨别能力更好，但福谢皮瓣确保供区并发症可忽略不计、皮质完全重新定向以及手部整体功能更佳。
