Zheng Huaiyuan, Liu Juan, Dai Xinyi, Machens Hans-Günther, Schilling Arndt F
Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
J Reconstr Microsurg. 2015 May;31(4):277-82. doi: 10.1055/s-0034-1396754. Epub 2015 Jan 28.
The aim of this study was to evaluate the esthetic and sensory outcomes after reconstruction of finger pulp defects with free toe flaps from the lateral aspect of the great toe.
From June 2006 to October 2011, we performed 48 free toe pulp transfers for finger pulp reconstruction in 43 patients; 18 male and 25 female patients with a mean age of 31.8 years (range, 16-47 years). Six patients suffered multiple digital pulp defects and five received two synchronous pulp transfers. The defects involved 20 thumbs, 15 index fingers, 10 long fingers, and 4 ring fingers, and flap size ranged from 24 × 18 to 55 × 30 mm. Follow-up evaluation included the functional and esthetic outcomes of the reconstructed pulps and donor toes.
All but one flap survived completely. Overall, 32 cases (35 pulp flaps) were followed for more than 1 year (range, 12-48 months; average, 22.8 months). The Semmes-Weinstein sensitivity score was 2.83 to 4.74 at the flaps and the mean static two-point discrimination was 6.17 mm (range, 3-10 mm). A total of 13 patients (40.6%) experienced mild (10 cases) to moderate (3 cases) cold intolerance, and 1 patient (3.1%) suffered severe cold intolerance. According to the Michigan Hand Outcome Questionnaire the mean esthetic appearance score was 16 (range, 12-19).
The free neurovascular great toe pulp flap is an efficient and reliable flap for the reconstruction of finger pulp defects.
本研究旨在评估采用拇趾外侧游离趾腹皮瓣修复手指指腹缺损后的美学和感觉效果。
2006年6月至2011年10月，我们对43例患者进行了48例游离趾腹皮瓣移植修复手指指腹缺损手术；其中男性18例，女性25例，平均年龄31.8岁（范围16 - 47岁）。6例患者存在多个手指指腹缺损，5例患者接受了同期双趾腹皮瓣移植。缺损涉及20个拇指、15个示指、10个中指和4个环指，皮瓣大小范围为24×18至55×30毫米。随访评估包括重建指腹和供区趾的功能及美学效果。
除1例皮瓣外，其余皮瓣均完全存活。总体而言，32例（35个趾腹皮瓣）随访时间超过1年（范围12 - 48个月；平均22.8个月）。皮瓣处Semmes - Weinstein感觉评分在2.83至4.74之间，平均静态两点辨别觉为6.17毫米（范围3 - 10毫米）。共有13例患者（40.6%）经历了轻度（10例）至中度（3例）的冷不耐受，1例患者（3.1%）出现严重冷不耐受。根据密歇根手功能结果问卷，美学外观平均评分为16分（范围12 - 19分）。
游离趾腹皮瓣是修复手指指腹缺损的一种有效且可靠的皮瓣。
