Wang Hui, Yang Xiaoxi, Chen Chao, Wang Bin, Wang Wei, Jia Song
1 Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, Hebei, PR China.
2 The College of Traditional Chinese Medicine, North China University of Science and Technology, Tangshan, Hebei, PR China.
J Hand Surg Eur Vol. 2018 Jun;43(5):546-553. doi: 10.1177/1753193417754191. Epub 2018 Feb 12.
The Littler flap has been widely used to repair large pulp defects of the thumb; however, several complications have occurred frequently. In order to reduce these issues, the modified Littler flap innervated by the dorsal branch of the proper digital nerve and the proper digital nerve from the ulnar aspect of the middle finger or the radial aspect of the ring finger were devised in 16 consecutive cases. At the donor site, the defect of the proper digital nerve was repaired with a nerve graft from the proximal portion of the ipsilateral dorsal branch of the proper digital nerve. At the final follow-up, the scores for the static two-point discrimination test, Semmes-Weinstein monofilament test and total active motions in both recipient and donor fingers were nearly normal. This modified Littler flap provides a simple and reliable alternative for treatment of large defects of the thumb pulp with low donor-site morbidity.
IV.
利特勒皮瓣已被广泛用于修复拇指的大面积 pulp 缺损；然而，经常出现一些并发症。为了减少这些问题，在连续16例病例中设计了由指固有神经背侧支和来自中指尺侧或环指桡侧的指固有神经支配的改良利特勒皮瓣。在供区，指固有神经缺损用同侧指固有神经背侧支近端的神经移植修复。在最后随访时，受区和供区手指的静态两点辨别试验、Semmes-Weinstein单丝试验和总主动活动评分几乎正常。这种改良的利特勒皮瓣为治疗拇指 pulp 大面积缺损提供了一种简单可靠的替代方法，且供区发病率低。
IV。
