Ould-Slimane M, Guinet V, Foulongne E, Melconian A, Beccari R, Milliez P-Y, Auquit-Auckbur I
Service de chirurgie orthopédique et de traumatologie, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex 1, France.
Chir Main. 2013 Oct;32(5):317-21. doi: 10.1016/j.main.2013.08.005. Epub 2013 Sep 20.
In Dupuytren's disease, correction of severe contracture deformities and excision of dermal lesions are often responsible for palmar skin defects. This study aimed to assess the results of the lateral digital flap described by Razemon. Thirty-seven patients were analysed retrospectively for functional and trophic results. Twelve months of follow-up were at least required. The lack of extension was appreciated through Thomine's coefficient. Subjective patient's opinion was noted about function of fifth finger and hand. The flap trophicity was evaluated through softness, coverage quality and esthetic aspect. In the preoperative period, the average lack of extension was 105°; 89% of the patients were ranked as stages 3 or 4 of Tubiana's classification. At the 12th month, the average Thomine's coefficient was 0.74; 70% of the patients were very satisfied. Two patients exhibited some lack of suppleness and seven a dyschromic scars. The lateral digital rotation flap is a quite simple surgical procedure. It allows satisfactory results corresponding to functional and trophic coverage in severe Dupuytren's contracture involving the fifth finger.
在掌腱膜挛缩症中，严重挛缩畸形的矫正和皮肤病变的切除常常导致手掌皮肤缺损。本研究旨在评估Razemon描述的指侧皮瓣的效果。对37例患者进行了回顾性分析，以评估功能和营养状况。至少需要12个月的随访。通过托米系数评估伸展受限情况。记录患者对小指和手部功能的主观意见。通过柔软度、覆盖质量和美观程度评估皮瓣的营养状况。术前，平均伸展受限为105°；89%的患者被列为图比亚纳分类的3期或4期。在第12个月时，平均托米系数为0.74；70%的患者非常满意。2例患者出现一定程度的柔韧性不足，7例有色素沉着异常的瘢痕。指侧旋转皮瓣是一种相当简单的手术方法。它能在涉及小指的严重掌腱膜挛缩中提供与功能和营养覆盖相应的满意效果。
