Aydin Hasan Utkan, Savvidou Christiana, Ozyurekoglu Tuna
Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY.
Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY.
J Hand Surg Am. 2019 Jul;44(7):616.e1-616.e7. doi: 10.1016/j.jhsa.2018.09.006. Epub 2018 Oct 23.
The homodigital dorsolateral flap (HDF) was described to treat various types of pulp and fingertip defects. The aim of this study was to analyze the intermediate-term function after fingertip reconstruction with HDF and compare these results with the cross-finger flap.
We analyzed a retrospective cohort of 25 patients. The HDF group consisted of 16 patients (18 fingertip defects) with a mean age of 44 years (range, 16-63 y). The cross-finger flap group consisted of 9 patients (10 fingertip defects) with a mean age of 33 years (range, 16-47 y). The average follow-up time was 12 months (range, 6-36 mo).
Patients with homodigital reconstruction demonstrated better sensibility in terms of mean static 2-point discrimination. Two-point discrimination was also better when the flap was advanced compared with when the flap was rotated. Mean distal interphalangeal joint range of motion for the HDF group was significantly better compared with the cross-finger flap group. Proximal interphalangeal joint range of motion was significantly better in the HDF group.
The HDF for reconstruction of pulp defects is a reliable option for 1-stage reconstruction. Related complications are minimal, and the intermediate-term functional results are better compared with cross-finger flaps.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
已描述了同指背外侧皮瓣（HDF）用于治疗各种类型的指腹和指尖缺损。本研究的目的是分析采用HDF进行指尖重建后的中期功能，并将这些结果与邻指皮瓣进行比较。
我们分析了一个包含25例患者的回顾性队列。HDF组由16例患者（18个指尖缺损）组成，平均年龄44岁（范围16 - 63岁）。邻指皮瓣组由9例患者（10个指尖缺损）组成，平均年龄33岁（范围16 - 47岁）。平均随访时间为12个月（范围6 - 36个月）。
同指重建的患者在平均静态两点辨别觉方面显示出更好的感觉功能。与皮瓣旋转时相比，皮瓣推进时的两点辨别觉也更好。HDF组的平均远侧指间关节活动度明显优于邻指皮瓣组。HDF组的近侧指间关节活动度也明显更好。
用于重建指腹缺损的HDF是一期重建的可靠选择。相关并发症极少，与邻指皮瓣相比，中期功能结果更好。
研究类型/证据水平：治疗性IV级。
