Lu Junyue, Cui Haojie, Zhang Wei, Li Qichao, He Kuile, Peng Yongli, Bian Zhaohui
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Dec;27(12):1480-3.
To investigate the effectiveness of cross finger flap pedicled with the dorsal branch of proper digital artery in repairing degloving injury of the fingertip.
Between January 2010 and June 2012, 13 cases of degloving injury of single fingertip were treated, including 9 males and 4 females with an average age of 33.6 years (range, 17-46 years). The defect locations were index finger in 5 cases, middle finger in 3 cases, ring finger in 3 cases, and little finger in 2 cases, including 4 cases of mechanical injury, 6 cases of twist injury, and 3 cases of crushing injury. The extent of skin avulsion was beyond the distal interphalangeal joint. The length of the avulsion was 1.0-2.1 cm (mean, 1.8 cm). Complicated injuries included phalangeal fracture in 2 cases. The time from injury to operation was 90-330 minutes (mean, 150 minutes). The wound was repaired with the cross finger flap pedicled with the dorsal branch of proper digital artery. The size of flaps ranged from 3.2 cm x 2.3 cm to 4.2 cm x 3.1 cm. After 3-4 weeks, the pedicle was cut. The donors were closed by skin graft.
Tension blisters of the flap and partial necrosis of skin graft occurred in 3 cases and in 1 case respectively, which were cured after symptomatic treatment; the flap and skin graft survived, and primary healing was obtained in the other cases. Thirteen patients were followed up 6-10 months (mean, 7 months). The texture and appearance of all the flaps were satisfactory. At 6 months after operation, two-point discrimination ranged from 7 to 10 mm (mean, 8.1 mm). The total active movement of the fingers were excellent in 10 cases and good in 3 cases, and the excellent and good rate was 100%.
The treatment of degloving injury of fingertip with the cross finger flap pedicled with the dorsal branch of proper digital artery is recommendable for the advantages of reliable blood supply, simple operation, high survival rate of the flap, good function recovery of the finger, and satisfactory appearance.
探讨指固有动脉背侧支带蒂交叉手指皮瓣修复指尖脱套伤的疗效。
2010年1月至2012年6月，治疗单指指尖脱套伤13例，其中男9例，女4例，平均年龄33.6岁（17 - 46岁）。缺损部位：示指5例，中指3例，环指3例，小指2例；致伤原因：机械伤4例，捻挫伤6例，挤压伤3例。皮肤撕脱范围超过远侧指间关节，撕脱长度1.0 - 2.1 cm（平均1.8 cm）。合并伤：指骨骨折2例。伤后至手术时间90 - 330分钟（平均150分钟）。采用指固有动脉背侧支带蒂交叉手指皮瓣修复创面，皮瓣大小为3.2 cm×2.3 cm至4.2 cm×3.1 cm。3 - 4周后断蒂，供区植皮闭合。
3例皮瓣出现张力性水疱，1例植皮部分坏死，经对症处理后治愈；其余病例皮瓣及植皮均成活，创面一期愈合。13例患者随访6 - 10个月（平均7个月），所有皮瓣质地、外观满意。术后6个月两点辨别觉为7 - 10 mm（平均8.1 mm）。手指总主动活动度：优10例，良3例，优良率100%。
指固有动脉背侧支带蒂交叉手指皮瓣修复指尖脱套伤，具有血供可靠、操作简单、皮瓣成活率高、手指功能恢复好、外观满意等优点，值得推广应用。
