Díaz Luis C, Vergara-Amador Enrique, Fuentes Losada Lina M
*Asotrauma Clinic, Ibagué †Orthopedics and Traumatology Unit, Faculty of Medicine, National University of Colombia, Bogotá, Colombia.
Tech Hand Up Extrem Surg. 2016 Dec;20(4):133-136. doi: 10.1097/BTH.0000000000000132.
The volar V-Y flap is used in transverse or dorsal oblique amputations in fingertip injuries; however, its use is contraindicated in patients with volar oblique amputations and cannot advance distally enough to cover the defect. The aim of this report is to describe a technique of double V-Y flap to cover fingertip defects in which a simple V-Y flap is not enough. This technique allows advancement between 30% and 50% farther than the original, simple V-Y flap. Report of cases a series of fingertip amputation covered with this technique. This technique was performed in 7 patients between 25 and 64 years old, with transverse, volar and dorsal oblique defects in the fingertip. The advancing of the flap was between 3 and 5 mm. There were no infections or necrosis of the flaps. In all patients there were acceptable aesthetic results with 2-point discrimination between 4 and 6 mm in the proximal flap and up to 10 mm in the distal flap with a minimum follow-up of 6 months. With this double V-Y flap, we have seen a good coverage even in volar oblique amputation. In addition, it is possible to advance up to 5 mm more with this second V-Y flap without compromising the vitality of the flap. It is a simple and reproducible technique that can be used on any finger, with good results, without flap necrosis.
掌侧V-Y皮瓣用于指尖损伤的横行或背侧斜行截肢；然而，在掌侧斜行截肢患者中禁用，且其向远端推进的距离不足以覆盖缺损。本报告的目的是描述一种双V-Y皮瓣技术，用于覆盖单纯V-Y皮瓣不足以覆盖的指尖缺损。该技术比原始的单纯V-Y皮瓣多推进30%至50%。病例报告 一系列采用该技术覆盖的指尖截肢病例。7例年龄在25至64岁之间的患者接受了该技术治疗，指尖存在横行、掌侧和背侧斜行缺损。皮瓣推进距离为3至5毫米。皮瓣无感染或坏死情况。所有患者均获得了可接受的美学效果，近端皮瓣两点辨别觉为4至6毫米，远端皮瓣可达10毫米，最短随访6个月。采用这种双V-Y皮瓣，即使在掌侧斜行截肢中也能实现良好的覆盖。此外，第二个V-Y皮瓣可多推进5毫米而不影响皮瓣活力。这是一种简单且可重复的技术，可用于任何手指，效果良好，无皮瓣坏死。
