Tan Haitao, Luo Xiang, Yang Keqin, Jiang Jianzhong, Wei Pingou, Zhao Jinming
Haitao Tan MD, Xiang Luo MD, Keqin Yang MD, Jianzhong Jiang MD, Pingou Wei MD, Orthopedics Department, The Eight Affiliated Hospital of Guangxi Medical University, 537100, Guigang, China.
Arch Bone Jt Surg. 2014 Mar;2(1):11-6. Epub 2014 Mar 15.
To introduce our experience of using the free neurovascular flap from great and second toe.
Thirteen patients (fifteen fingers) sought surgical treatment for soft tissue defects of the hand at our medical institution between March 2006 and September 2009. In two patients, fibular side skin-nail flaps of great toe were applied to cover the dorsal defect of distal thumb. In twelve, the treatment was carried out for the pulp defect of finger with fibular side flap of great toe or tibial side flap of second toe. In one, the treatment was carried out for the defect of distal middle with composite flap with distal digital bone of second toe.
All flaps survived. The average subjective satisfaction score was 8.08 (range 4-10). Nine patients (69%) experienced cold intolerance, and 2 patients (15%) dysesthesia. The Semmes-Weinstein sensitivity score was between 3.47and 4.72 on the flap, and 0-4.18 on the donor site. The mean two-point discrimination was 6.8 mm (range 4-12). Grip strength was 10% less than in the unaffected hand. The proximal interphalangeal mobility loss was less than 15 degrees.
Our results indicated that these free flaps from toe are useful for patients with a small soft-tissue defect in hand.
介绍我们使用拇趾和第二趾游离神经血管皮瓣的经验。
2006年3月至2009年9月期间，13例患者（15指）在我院寻求手部软组织缺损的手术治疗。2例患者采用拇趾腓侧皮甲瓣修复拇指末节背侧缺损。12例患者采用拇趾腓侧皮瓣或第二趾胫侧皮瓣修复手指指腹缺损。1例患者采用带第二趾末节趾骨的复合皮瓣修复中远节缺损。
所有皮瓣均存活。主观满意度平均评分为8.08分（范围4 - 10分）。9例患者（69%）有冷不耐受，2例患者（15%）有感觉异常。皮瓣处Semmes-Weinstein感觉评分在3.47至4.72之间，供区评分在0至4.18之间。平均两点辨别觉为6.8毫米（范围4 - 12毫米）。握力比健侧手少10%。近端指间关节活动度丧失小于15度。
我们的结果表明，这些来自足部的游离皮瓣对手部软组织小缺损患者有用。
