Department of Hand Surgery, the Second Hospital of Jilin University, Changchun, 13000, Jilin, China.
BMC Surg. 2021 Jan 22;21(1):52. doi: 10.1186/s12893-020-00994-3.
The treatment of defects on the volar surface of the finger has been scarcely reported, and its utility for digital resurfacing remains unclear. This study compared the outcomes of free medial plantar artery flap (MPAF) and dorsal digital-metacarpal flap (DDMF) in finger reconstruction.
This retrospective cohort study included 24 patients with soft-tissue defects on the volar surface of the finger from March 2014 to March 2017. The patients were divided into two groups: the MPAF group and the DDMF group. The operation time, complications, such as flap necrosis, graft loss, infection, paresthesia, and donor-site morbidity, as well as two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire was used for conduct follow-up assessment.
After more than 12 months of follow-up, the MPAF group had a longer operative time compared with DDMF group, but there was no significant difference between postoperative complications and 2-PD test result in patients without nerve injury. And in terms of overall function, Modified VSS score and 2-PD test (the patients with nerve injury), There were relatively obvious statistical differences, MPAF was superior to DDMF (p < 0.005).
MPAF and DDMF are reliable for reconstruction of the volar surface of the finger; however, MPAF offers better functional outcomes and is associated with a lower incidence of postoperative complications.
手指掌侧缺损的治疗鲜有报道，其在手指再植中的应用尚不清楚。本研究比较了游离足底内侧动脉皮瓣（MPAF）和指背-掌骨皮瓣（DDMF）在手指重建中的效果。
这是一项回顾性队列研究，纳入 2014 年 3 月至 2017 年 3 月间 24 例手指掌侧软组织缺损患者。患者分为 MPAF 组和 DDMF 组。仔细记录手术时间、并发症（如皮瓣坏死、移植丢失、感染、感觉异常和供区并发症）以及两点辨别觉（2-PD）。采用密歇根手功能问卷（MHQ）进行随访评估。
随访 12 个月以上，MPAF 组的手术时间长于 DDMF 组，但无神经损伤患者的术后并发症和 2-PD 测试结果无显著差异。在总体功能、改良 VAS 评分和 2-PD 测试（有神经损伤患者）方面，MPAF 明显优于 DDMF（p < 0.005）。
MPAF 和 DDMF 是重建手指掌侧的可靠方法；然而，MPAF 提供了更好的功能结果，并且术后并发症发生率较低。
