Ni Feng, Appleton Sarah E, Chen Bo, Wang Bin
Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
J Hand Surg Am. 2012 Sep;37(9):1806-11. doi: 10.1016/j.jhsa.2012.05.003. Epub 2012 Jul 2.
Sensate reconstruction with glabrous skin is essential for ideal resurfacing of fingertip and pulp defects. The purpose of this study was to examine the palmar pivot flap as a reconstructive option for fingertip and pulp defects.
We used the palmar pivot flap to repair fingertip and pulp defects in 21 consecutive patients. Outcomes measured included range of motion of the distal interphalangeal and proximal interphalangeal joints, sensation, pain, cold intolerance, and percussion tenderness. We assessed patient satisfaction with the aesthetic outcome using the Michigan Hand Outcomes Questionnaire.
All flaps survived. We achieved complete mobility at the distal interphalangeal and proximal interphalangeal joints. Sensory recovery was demonstrated in all flaps within 2 weeks postoperatively. No painful tips were reported at an average follow-up of 11 months. All flaps had mild cold intolerance, and 1 patient reported mild percussion tenderness. All patients were satisfied with the appearance of the reconstructed fingertips.
The palmar pivot flap can provide sensate glabrous skin for the effective reconstruction of fingertip and pulp defects, resulting in aesthetically pleasing and good functional outcomes.
使用无毛皮肤进行感觉重建对于指尖和指腹缺损的理想修复至关重要。本研究的目的是探讨掌侧枢轴皮瓣作为指尖和指腹缺损的一种重建选择。
我们连续对21例患者使用掌侧枢轴皮瓣修复指尖和指腹缺损。测量的结果包括远侧指间关节和近侧指间关节的活动范围、感觉、疼痛、冷不耐受和叩击压痛。我们使用密歇根手部结果问卷评估患者对美学效果的满意度。
所有皮瓣均存活。我们在远侧指间关节和近侧指间关节实现了完全活动度。术后2周内所有皮瓣均显示感觉恢复。平均随访11个月时未报告有疼痛的指尖。所有皮瓣均有轻度冷不耐受，1例患者报告有轻度叩击压痛。所有患者对重建指尖的外观均满意。
掌侧枢轴皮瓣可为指尖和指腹缺损的有效重建提供有感觉的无毛皮肤，从而产生美观且功能良好的结果。
