Spies Christian K, Müller Lars P, Oppermann Johannes, Langer Martin F, Hohendorff Bernd, Löw Steffen, Unglaub Frank
Abteilung für Handchirurgie, Vulpius Klinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland.
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Oper Orthop Traumatol. 2020 Dec;32(6):477-485. doi: 10.1007/s00064-020-00681-9. Epub 2020 Nov 13.
Reliable wound coverage of the fingertip and palmar aspect of the middle finger with a sensate flap in order to restore early function.
Palmar, oblique pulp defects or amputations at the distal finger phalange with uncovered bone, tendons, and/or neurovascular structures.
Peripheral perfusion deficiency, size of defect exceeding flap capacity, obliteration of the flap artery, i.e. contralateral finger artery.
Harvesting of adipocutane, midlateral triangle based on proper digital vessel flap; distal flap transposition and primary closure of the harvesting defect, flap dimension 4-5 mm larger than defect.
Finger splint for 2 weeks, followed by exercises with flap conditioning.
Very reliable defect coverage with 9% minor and temporary complications, all of which healed without consequences.
用带感觉的皮瓣可靠覆盖指尖和中指掌面，以尽早恢复功能。
掌侧、斜行的指腹缺损或远节指骨截肢，伴有外露的骨骼、肌腱和/或神经血管结构。
外周灌注不足、缺损大小超过皮瓣覆盖能力、皮瓣动脉闭塞，即对侧指动脉。
基于合适的指动脉皮瓣切取含脂肪的中侧三角皮瓣；将远端皮瓣转移并一期闭合供区缺损，皮瓣尺寸比缺损大4-5毫米。
手指夹板固定2周，随后进行皮瓣适应性锻炼。
缺损覆盖非常可靠，轻微和暂时性并发症发生率为9%，所有并发症均愈合且无后遗症。
