Santos Tarsila Pagnan Silva Dos, Oliveira Marcelo Tavares de, Angelini Luiz Carlos
Hospital do Servidor Público Municipal (HSPM), Departamento de Ortopedia e Traumatologia, Centro de Cirurgia e Microcirurgia da Mão, São Paulo, SP, Brazil.
Rev Bras Ortop. 2018 Feb 27;53(2):200-207. doi: 10.1016/j.rboe.2017.01.011. eCollection 2018 Mar-Apr.
To assess the homodigital flap surgical procedure, as well as the function of the finger, pain, sensation, esthetics, and patient satisfaction.
Retrospective analysis of records and questionnaires of patients who underwent this surgical technique between the months of May 2013 and October 2016. Eight were included in the study, with an average follow-up period of 23 months. Patients with digital pulp lesions of the thumbs and those who did not perform rehabilitation were excluded. All underwent the two-point discrimination test, the Semmes-Weinstein test, and range of motion evaluation. The age varied from 22 to 59 years (average of 32.9), six (75%) being male patients.
Three patients (37.5%) had involvement of the right hand and five of the left (62.5%). Regarding the etiology, seven suffered injury and one a chemical burn. The average distance obtained from the two-point discrimination test was 7.3 mm. All patients who underwent the Semmes-Weinstein test obtained response to the purple filament. The average sum of the range of motion of the affected digit was 98.9%. The flap area was on average 294.4 mm. The return to work averaged seven weeks. A positive Tinel sign was found in the donating area and two reported intolerance to cold. Partial or total necrosis of the flap was not observed.
The homodigital flap technique presented satisfactory esthetics and functional results regarding feasibility, sensation, and digital mobility in pulp lesions.
评估同指皮瓣手术操作以及手指功能、疼痛、感觉、美观度和患者满意度。
对2013年5月至2016年10月间接受该手术技术的患者记录和问卷进行回顾性分析。8例患者纳入研究,平均随访期为23个月。排除拇指指腹损伤患者以及未进行康复治疗的患者。所有患者均接受两点辨别试验、Semmes-Weinstein试验和活动度评估。年龄从22岁至59岁不等(平均32.9岁),6例(75%)为男性患者。
3例患者(37.5%)右手受累,5例左手受累(62.5%)。病因方面,7例为外伤,1例为化学烧伤。两点辨别试验的平均距离为7.3毫米。所有接受Semmes-Weinstein试验的患者对紫色细丝均有反应。患指活动度总和平均为98.9%。皮瓣面积平均为294.4平方毫米。平均7周后恢复工作。供区发现阳性Tinel征,2例报告不耐冷。未观察到皮瓣部分或全部坏死。
同指皮瓣技术在指腹损伤的可行性、感觉和手指活动度方面呈现出令人满意的美观和功能效果。