Silva J Braga, Faloppa F, Albertoni W, Gazzalle A, Cunha G L da
Service of Hand Surgery and Reconstructive Microsurgery, Hospital Sao Lucas, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
J Hand Surg Eur Vol. 2013 May;38(4):371-7. doi: 10.1177/1753193412439168. Epub 2012 Feb 22.
The purpose of this report is to show how our anatomical findings have influenced the design of the dorsal homodigital adipofascial turnover arterial flap to the thumb. Thirty-six thumbs from 18 fresh cadavers were dissected at the Fèr à Moulin Laboratoire (Paris, France) between January 1998 and March 1999. All branches of the proper digital artery (PDA) were identified. During the clinical study, from 2002 to 2008, 12 patients with dorsal thumb skin defects were treated with adipofascial turnover flaps. The dorsal branches of the PDA typically emerge at the level of the metacarpophalangeal and interphalangeal joints, 10 mm apart from the joint line. Based on the anatomical study, the flap could be designed predictably and reliably. The main advantages of dorsal adipofascial turnover flaps include their simplicity; the possibility of a one stage procedure; avoiding the use of tissue from elsewhere on the limb/body; minimal donor-site deformity; and avoidance of damage to the volar digital arteries.
本报告的目的是展示我们的解剖学发现如何影响了拇指背侧同指脂肪筋膜翻转动脉皮瓣的设计。1998年1月至1999年3月期间，在法国巴黎的费拉穆林实验室对18具新鲜尸体的36个拇指进行了解剖。确定了指固有动脉（PDA）的所有分支。在2002年至2008年的临床研究中，12例拇指背侧皮肤缺损患者接受了脂肪筋膜翻转皮瓣治疗。PDA的背侧分支通常出现在掌指关节和指间关节水平，距关节线10毫米。基于解剖学研究，该皮瓣可以可预测且可靠地设计。拇指背侧脂肪筋膜翻转皮瓣的主要优点包括操作简单；可一期手术；避免使用肢体/身体其他部位的组织；供区畸形最小；以及避免损伤指掌侧动脉。
