Qian Jun, Rui Yongjun, Zhang Quanrong, Xue Mingyu, Zhang Zhihai
Department of Hand Surgery, Hand Surgery Hospital of Wuxi, Wuxi Jiangsu 214061, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Nov;25(11):1347-9.
To investigate the effectiveness of dorsal metacarpal island flap for treating scar contracture of the finger web.
Between June 2009 and December 2010, 10 patients with scar contracture of the finger web were treated. There were 6 males and 4 females with an average age of 30 years (range, 14-57 years). Scar contracture was caused by injury in 8 cases, by burn in 1 case, and by operation in 1 case. The locations were the 1st web space in 1 case, the 2nd web space in 3 cases, the 3rd web space in 5 cases, and the 4th web space in 1 case. The disease duration was 3 to 9 months with an average of 5 months. The maximum abduction was 10-20 degrees. After web space scar release, the dorsal metacarpal island flap (3.5 cm x 1.2 cm-4.0 cm x 2.0 cm in size) was used to reconstruct web space (2.0 cm x 1.0 cm-3.0 cm x 1.8 cm in size). The donor site was directly sutured or repaired with local flaps.
At 2 days after operation, necrosis occurred in 1 flap, which healed by extractive treatment. The other flaps survived and wound healed by first intention; all the flaps at donor sites survived and incision healed by first intention. Ten patients were followed up 6 to 15 months (mean, 9 months). The reconstructed web space had good appearance, the maximum abduction was 80 degrees in 1 case of the 1st web space scars contracture, and the maximum abduction was 35-45 degrees (mean, 40 degrees) in the other 9 cases. In 8 scar patients causing by injury, no scar contracture recurred during follow-up.
It can achieve good results in appearance and function to use dorsal metacarpal island flap for treating scar contracture of the finger web.
探讨手背掌侧岛状皮瓣治疗指蹼瘢痕挛缩的疗效。
2009年6月至2010年12月，治疗10例指蹼瘢痕挛缩患者。其中男6例，女4例，平均年龄30岁（14～57岁）。瘢痕挛缩原因：外伤8例，烧伤1例，手术1例。部位：第1指蹼间隙1例，第2指蹼间隙3例，第3指蹼间隙5例，第4指蹼间隙1例。病程3～9个月，平均5个月。最大外展度为10～20度。指蹼间隙瘢痕松解后，采用手背掌侧岛状皮瓣（大小为3.5 cm×1.2 cm～4.0 cm×2.0 cm）修复指蹼间隙（大小为2.0 cm×1.0 cm～3.0 cm×1.8 cm）。供区直接缝合或采用局部皮瓣修复。
术后2天，1例皮瓣发生坏死，经换药后愈合。其余皮瓣均成活，创面一期愈合；所有供区皮瓣均成活，切口一期愈合。10例患者随访6～15个月（平均9个月）。修复后的指蹼外观良好，第1指蹼间隙瘢痕挛缩患者1例最大外展度为80度，其余9例最大外展度为35～45度（平均40度）。8例外伤所致瘢痕患者随访期间无瘢痕挛缩复发。
采用手背掌侧岛状皮瓣治疗指蹼瘢痕挛缩，在外观和功能方面均可取得良好效果。
