Xiao Zhou, Yongjun Rui, Mingyu Xue, Yajun Xu, Li Qiang, Heping Zheng
Zhonghua Zheng Xing Wai Ke Za Zhi. 2015 May;31(3):188-91.
To summarize the therapeutic effect of free perforator hypothenar flap for thumb pulp defect.
From Jun. 2012 to Mar. 2013,8 cases with thumb pulp defect accompanied with exposure of phalanges ans tendons were treated by free ipsilateral perforator hypothenar flap. The flaps were 1.4 cm x 2.0 cm-1.8 cm x 2.2 cm in size. Ulnar finger artery in the flap was anastomosed with thumb artery. The accompanied veins and superficial veins were respectively anastomosed with thumb dorsal veins. Nerve branches in flaps were sutured with unilateral finger nerve to reconstruct flap feeling with 9-0 thread. Wounds in the hypothenar donor site were sutured directly.
All the flaps survived completely with primary healing both in donor and recipient area. 8 cases (8 fingers) were followed up for 6-13 months (average 9 months). The flaps appearance, texture were good. The two-point discrimination distance on flap was 7-10 mm. The active and passive movement of thumb joints was normal. There was no complain about the feeling at the donor site. Linear scar was left on the donor site. Patients hand grip strength was not decreased.
The free perforator hypothenar flap which has constant vascular anatomy is a new method for thumb soft tissue defect with less morbidity to donor site. The operative procedures are relatively simple.
总结游离小鱼际穿支皮瓣修复拇指指腹缺损的治疗效果。
2012年6月至2013年3月，采用同侧游离小鱼际穿支皮瓣修复8例拇指指腹缺损伴指骨及肌腱外露患者。皮瓣大小为1.4 cm×2.0 cm - 1.8 cm×2.2 cm。将皮瓣内的尺侧指动脉与拇指动脉吻合，伴行静脉及浅静脉分别与拇指背侧静脉吻合。用9-0缝线将皮瓣内神经分支与单侧指神经缝合，重建皮瓣感觉。小鱼际供区伤口直接缝合。
所有皮瓣全部成活，供区和受区均一期愈合。8例（8指）随访6 - 13个月（平均9个月）。皮瓣外观、质地良好。皮瓣两点辨别觉为7 - 10 mm。拇指关节主动和被动活动正常。供区无感觉异常。供区遗留线性瘢痕。患者握力未下降。
游离小鱼际穿支皮瓣血管解剖恒定，是修复拇指软组织缺损的一种新方法，对供区损伤较小。手术操作相对简单。
