Usami Satoshi, Inami Kohei, Hirase Yuichi, Mori Hiroki
Department of Hand Surgery, Takatsuki Orthopaedic Hospital, Tokyo, Japan.
Department of Hand Surgery and Microsurgery, Yotsuya Medical Cube, Tokyo, Japan.
J Hand Surg Eur Vol. 2020 Oct;45(8):842-848. doi: 10.1177/1753193420939379. Epub 2020 Jul 5.
We present outcomes of using a perforator-based ulnar parametacarpal flap in 25 patients for digital pulp defects. These included 17 free transfers to the thumb, index, middle and ring fingers and eight reverse pedicled transfers to the little fingers. This flap includes a dorsal sensory branch of the ulnar nerve, which was sutured to the digital nerve in all transfers. Each flap had one to three reliable perforators (mean 0.44 mm diameter) to the ulnar parametacarpal region and contained at least one perforator within 2 cm proximal to the palmar digital crease. All the 25 flaps survived completely. Twenty-two patients were followed for 15 months (range 12 to 24), and three were lost to follow-up. The mean static and moving two-point discrimination of the flap was 7 mm and 5 mm, respectively. At the donor site, sensory reinnervation was acceptable. We conclude that ulnar parametacarpal perforator flaps offer sensate, thick and glabrous skin for finger pulp repair, all in a single operative field. IV.
我们展示了25例使用基于穿支的尺侧掌骨旁皮瓣修复指腹缺损患者的治疗结果。其中包括17例游离移植至拇指、示指、中指和环指，8例逆行带蒂移植至小指。该皮瓣包含尺神经的一支背侧感觉支，在所有移植中均将其与指神经缝合。每个皮瓣有1至3支可靠的穿支（平均直径0.44毫米）供应尺侧掌骨区域，且在掌指横纹近端2厘米范围内至少有1支穿支。25例皮瓣全部完全存活。22例患者随访15个月（范围12至24个月），3例失访。皮瓣静态和动态两点辨别觉平均分别为7毫米和5毫米。供区感觉再支配情况尚可。我们得出结论，尺侧掌骨穿支皮瓣可为指腹修复提供有感觉、厚实且无毛的皮肤，且均在单一术野内完成。四、
