Balan Jyoshid R, Mathew Shaji, Kumar Pradeep, Vardhan Harsh, Francis Anto, Aniljith V G, Gopal Raj
Sushrutha Institute of Plastic Reconstructive and Aesthetic Surgery, Elite Mission Hospital, Thrissur, Kerala, India.
Indian J Plast Surg. 2018 Jan-Apr;51(1):54-59. doi: 10.4103/ijps.IJPS_37_17.
The finger skin and soft-tissue defects are reconstructive challenges due to their nature and the intricate extensor apparatus and flexors it protects. The reverse dorsal metacarpal artery (RDMA) is a time-tested option for the reconstruction of the same.
A total of 14 cases of RDMA flap for finger defects involving proximal to distal phalanx were performed. Thirteen of these patients were male and one patient female and the most common mode of injury was occupational in nature followed by road traffic accident. The overall appearance was assessed for the flap and the donor site. The associated injuries and the range of motion were noted.
All but one flap survived completely. One patient had partial distal flap loss, which was tackled with split-thickness skin grafting. The flap size varied from 3.5 cm × 1.5 cm to 9 cm × 2 cm with mean of 6.64 cm × 1.72 cm. The mean age of the patients was 33.4 years. All the patients had acceptable aesthesis. The donor site had no complications and healed with linear scar.
RDMA flap is a reliable flap for finger defects reconstruction. The range of movement mainly depends on the associated injury rather than flap transfer alone and to prove this we require doing analysis of range of movement in patients with flap done alone or with associated injuries.
手指皮肤和软组织缺损因其自身性质以及其所保护的复杂伸肌装置和屈肌，给重建带来了挑战。逆行掌背动脉（RDMA）皮瓣是用于此类重建的经过长期验证的选择。
共对14例涉及近节指骨至远节指骨的手指缺损患者实施了RDMA皮瓣手术。其中13例为男性，1例为女性，最常见的损伤方式为工伤，其次是道路交通事故。对皮瓣和供区的整体外观进行评估。记录相关损伤情况及活动范围。
除1例皮瓣外，其余皮瓣均完全存活。1例患者出现皮瓣远端部分坏死，通过刃厚皮片移植处理。皮瓣大小从3.5 cm×1.5 cm至9 cm×2 cm不等，平均为6.64 cm×1.72 cm。患者的平均年龄为33.4岁。所有患者的感觉均可接受。供区无并发症，愈合后留下线性瘢痕。
RDMA皮瓣是用于手指缺损重建的可靠皮瓣。活动范围主要取决于相关损伤，而非单纯的皮瓣转移，为证实这一点，我们需要对单纯接受皮瓣手术或伴有相关损伤的患者的活动范围进行分析。
