Kwon Yu-Jun, Ahn Byung-Moon, Lee Jae-Sung, Park Yong-Gum, Ryu Hyun-Jun, Ha Yong-Chan
Department of Orthopedic Surgery, Sungmin General Hospital, Incheon, Republic of Korea.
Department of Orthopaedic Surgery, School of Medicine, Chung-Ang University, Seoul, Republic of Korea.
Injury. 2017 Feb;48(2):481-485. doi: 10.1016/j.injury.2016.12.023. Epub 2016 Dec 28.
Although thenar flap for single fingertip amputation is a common and popular surgical technique, double thenar flap technique for patients with two fingertip amputations has rarely been reported in the literature. The purpose of this case-control study was to introduce the double thenar technique and compare the clinical outcomes between single thenar flap and double thenar flap surgical treatments.
From January 2005 to December 2014, 92 patients with single fingertip amputations were treated with thenar flap (Group I) and 28 patients with two fingertip amputations were treated with double thenar flap (Group II). These 120 patients were followed-up for a minimum of 12 months postoperatively. At the latest follow-up, the two groups were assessed for pain, cold intolerance in the reconstructed finger, functional outcomes by Chen's criteria, and subjective patient satisfaction.
At the final follow-up, all flaps in both groups had survived. No flap failure occurred. There was no significant difference in cold intolerance (p=0.783), donor site pain (p=0.728), fingertip pain (p=1.000), or paresthesia (p=0.514) between the two groups. A total of 100 (83.3%) patients were completely or fairly satisfied. There was no significant difference in satisfaction between the two groups (p=0.801). According to the Chen criteria, 102 (85%) patients had excellent or good results.
This study demonstrated that the double thenar flap technique used for patients with two fingertip amputations produced complete survival with functional outcomes comparable to those of the single thenar flap technique at the last follow-up.
尽管大鱼际皮瓣用于单指指尖离断是一种常见且常用的外科技术，但文献中很少报道用于两指指尖离断患者的双侧大鱼际皮瓣技术。本病例对照研究的目的是介绍双侧大鱼际皮瓣技术，并比较单侧大鱼际皮瓣与双侧大鱼际皮瓣手术治疗的临床效果。
2005年1月至2014年12月，92例单指指尖离断患者接受大鱼际皮瓣治疗（I组），28例两指指尖离断患者接受双侧大鱼际皮瓣治疗（II组）。这120例患者术后至少随访12个月。在最近一次随访时，对两组患者的疼痛、再造手指的冷不耐受情况、根据陈氏标准评估的功能结果以及患者主观满意度进行评估。
在最后一次随访时，两组所有皮瓣均存活，未发生皮瓣坏死。两组在冷不耐受（p = 0.783）、供区疼痛（p = 0.728）、指尖疼痛（p = 1.000）或感觉异常（p = 0.514）方面无显著差异。共有100例（83.3%）患者完全或相当满意。两组在满意度方面无显著差异（p = 0.801）。根据陈氏标准，102例（85%）患者结果为优或良。
本研究表明，用于两指指尖离断患者的双侧大鱼际皮瓣技术皮瓣完全存活，在最后一次随访时功能结果与单侧大鱼际皮瓣技术相当。
