Rose E H
Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, California.
Clin Plast Surg. 1989 Jul;16(3):427-42.
Small defects of the hand and digits challenge the surgeon to use innovative methods of composite reconstruction for retention of digital length; aesthetic nail appearance; coverage of joint, implants, and tendons; release of scar contractures; and restoration of sensation in critical tactile surfaces. This article is by no means totally encompassing but an attempt to provide the reader with an insight into the author's select flap choices applying some of the newer microvascular methods. Descriptions include the volar advancement flap, free microvascular pulp transfer from the toe, "kite flap," onycho-osteocutaneous transfer, arterialized toe transposition, wrap-around flap, arterialized island pedicle, venous flow-through flap, and the free temporoparietal fascial flap. Options are influenced by morphological and physiological considerations, specifically in the fingertip, nail complex, volar surface of the digit, and dorsum of the hand.
手部和手指的小缺损对外科医生提出了挑战，要求他们采用创新的复合重建方法来保留手指长度、保持指甲美观、覆盖关节、植入物和肌腱、松解瘢痕挛缩以及恢复关键触觉表面的感觉。本文绝非全面涵盖所有内容，而是试图让读者深入了解作者应用一些较新的微血管方法所选择的皮瓣。描述内容包括掌侧推进皮瓣、来自脚趾的游离微血管指腹转移皮瓣、“风筝皮瓣”、甲-骨-皮瓣转移、动脉化脚趾转位、带蒂皮瓣、动脉化岛状蒂皮瓣、静脉血流通过皮瓣以及游离颞顶筋膜皮瓣。选择受形态学和生理学因素影响，特别是在指尖、指甲复合体、手指掌侧表面和手背部位。
