Ayhan Egemen, Çevik Kadir, Çelik Velat, Eskandari Metin Manouchehr
Division of Hand Surgery, Department of Orthopaedics and Traumatology, University of Health Sciences Turkey, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Department of Orthopaedics and Traumatology, Mersin University, School of Medicine, Mersin, Turkey.
Acta Orthop Traumatol Turc. 2020 May;54(3):269-275. doi: 10.5152/j.aott.2020.03.1.
The aim of this study was to evaluate the results of the innervated digital artery perforator (IDAP) flap and to analyze the relationship between patient satisfaction and outcome measures.
A total of 17 fingertips of 15 patients (14 men and one woman; mean age: 47.2 (26-62) years) were included in this retrospective study. Patients' injured finger and defect type were recorded. At the last follow-up, the static two-point discrimination (s2PD) test, Semmes Weinstein monofilament (SWM) test, and range of motion of the affected finger were analyzed. We interviewed patients to determine hand dominance, cold intolerance, and their satisfaction with the result. We performed correlation and logistic regression analyses between patient satisfaction and outcome measures.
The mean follow-up period was 13.8 (7-18) months. The mean range of motion was 77.3±3.5 (70-80) degrees for the distal interphalangeal joints of affected fingers. The mean s2PD was 6.4 (3-10) mm, and the SWM records ranged from 2.83 to 4.93 monofilament markings. Cold intolerance was noted in seven fingers (41%). Patient satisfaction was negatively correlated with cold intolerance, and cold intolerance decreased as the follow-up period extended.
IDAP flap satisfies both patient and surgeon, with the only significant problem being cold intolerance, regarding which patients must be informed. Although cold intolerance is hard to treat, fortunately, it generally improves with time.
Level IV, Therapeutic study.
本研究旨在评估带神经指动脉穿支皮瓣（IDAP皮瓣）的手术效果，并分析患者满意度与疗效指标之间的关系。
本回顾性研究纳入了15例患者（14例男性，1例女性；平均年龄：47.2（26 - 62）岁）的17个指尖。记录患者受伤手指及缺损类型。在末次随访时，分析静态两点辨别觉（s2PD）测试、Semmes Weinstein单丝试验（SWM）以及患指的活动度。我们对患者进行访谈，以确定手的优势侧、冷不耐受情况以及他们对手术结果的满意度。我们对患者满意度与疗效指标进行了相关性分析和逻辑回归分析。
平均随访时间为13.8（7 - 18）个月。患指远侧指间关节的平均活动度为77.3±3.5（70 - 80）度。平均s2PD为6.4（3 - 10）mm，SWM记录范围为2.83至4.93个单丝标记。7个手指（41%）存在冷不耐受。患者满意度与冷不耐受呈负相关，且冷不耐受情况随随访时间延长而减轻。
IDAP皮瓣使患者和外科医生都满意，唯一显著的问题是冷不耐受，对此必须告知患者。虽然冷不耐受难以治疗，但幸运的是，它通常会随时间改善。
IV级，治疗性研究。
