Lucchina S, Fusetti C, Lazzaro L, Nistor A, Guidi M
Hand Surgery Unit EOC, Surgical Department, Locarno's Regional Hospital, via Ospedale 1, 6600 Locarno, Switzerland.
Hand Surgery Unit EOC, Surgical Department, Locarno's Regional Hospital, via Ospedale 1, 6600 Locarno, Switzerland.
Hand Surg Rehabil. 2019 Jun;38(3):207-210. doi: 10.1016/j.hansur.2019.03.005. Epub 2019 Apr 3.
Optimal functional reconstruction of the palmar surface of the hand requires good sensibility especially for the thumb and the radial side of the fingers. We report the long-term results of a distally based radial forearm flap (RFF) used for soft tissue coverage in the palm, index and middle finger and an end-to-side neurorrhaphy between the lateral antebrachial cutaneous nerve (LACN) and the proper palmar digital nerve of the middle finger to restore sensation. At 5 years' follow-up, the patient's sensory recovery was assessed through static and moving two-point discrimination, light touch sensation, pain perception, hot and cold temperature perception, an electrophysiological study and sweat test. An S3+ sensory recovery on the British Medical Research Council scale, as modified by Mackinnon and Dellon, was noted together with a good perception in the palm compared to decreased perception in the volar surface of the proximal phalanx. These findings prove that the RFF can provide good functional coverage of the palm together with good sensitivity by end-to-side reinnervation.
手部掌面的最佳功能重建需要良好的感觉，尤其是拇指和手指桡侧。我们报告了以远端为蒂的桡侧前臂皮瓣（RFF）用于手掌、示指和中指软组织覆盖，以及前臂外侧皮神经（LACN）与中指指掌侧固有神经之间进行端侧神经缝合以恢复感觉的长期结果。在5年的随访中，通过静态和动态两点辨别觉、轻触觉、痛觉、冷热温度觉、电生理研究和发汗试验对患者的感觉恢复情况进行评估。按照Mackinnon和Dellon修改后的英国医学研究委员会标准，感觉恢复达到S3+，同时与近节指骨掌侧感觉减退相比，手掌感觉良好。这些结果证明，RFF通过端侧再支配能够为手掌提供良好的功能覆盖以及良好的感觉。
