Department of Orthopedic and Trauma Surgery, Ibn Tofail Hospital, Mohammed VI University Hospital Center, Abdelouahab Derraq Street, PB 40000 Marrakesh, Morocco.
Department of Orthopedic and Trauma Surgery, Ibn Tofail Hospital, Mohammed VI University Hospital Center, Abdelouahab Derraq Street, PB 40000 Marrakesh, Morocco.
Hand Surg Rehabil. 2021 Sep;40(4):484-490. doi: 10.1016/j.hansur.2021.04.003. Epub 2021 Apr 23.
While various techniques are used for the reconstruction of fingertip injuries, the main goals remain the same: preserve finger length, sensation, and function. The thenar flap is a well-described technique and simple procedure in fingertip amputations. This study aimed to evaluate the long-term functional and esthetic outcomes along with patient satisfaction of thenar flaps done for fingertip defects. Thenar flaps used in 32 patients operated between January 2010 and December 2016 were analyzed retrospectively to assess sensory recovery, range of motion, cold intolerance, pain relief, appearance, patient satisfaction, and QuickDASH score. All flaps survived, without adverse events. The flap was detached after 10-14 days (mean 12.5 days). The mean follow-up was 31 months (range, 20-45 months). According to Semmes-Weinstein monofilament test results, protective sensation was achieved in 25 patients (78%). The mean static 2-point discrimination was 6.1 mm. There were no functionally significant finger flexion contractures at the final follow-up. Complications such as pain, donor site morbidity and cold intolerance were not encountered. The thenar flap is an excellent technique for coverage of total or subtotal tissue loss of radial-side fingertips that is not accessible to local flaps. It provides good sensory function and appearance when fundamental technical principles (flap design, timing of division, and early mobilization) are respected.
虽然有各种技术可用于重建指尖损伤，但主要目标保持不变：保持手指长度、感觉和功能。鱼际皮瓣是一种描述良好的技术，在指尖离断伤中操作简单。本研究旨在评估鱼际皮瓣用于指尖缺损的长期功能和美学结果以及患者满意度。回顾性分析了 2010 年 1 月至 2016 年 12 月期间手术的 32 例患者的鱼际皮瓣，以评估感觉恢复、活动范围、对冷不耐受、疼痛缓解、外观、患者满意度和 QuickDASH 评分。所有皮瓣均存活，无不良事件。皮瓣在 10-14 天后（平均 12.5 天）分离。平均随访 31 个月（范围 20-45 个月）。根据 Semmes-Weinstein 单丝试验结果，25 例患者（78%）获得保护性感觉。静态 2 点辨别觉的平均距离为 6.1mm。在最终随访时，没有明显的手指弯曲挛缩。没有遇到疼痛、供区并发症和对冷不耐受等并发症。当尊重基本技术原则（皮瓣设计、分割时机和早期活动）时，鱼际皮瓣是覆盖桡侧指尖全部或部分组织缺失的极好技术。它提供了良好的感觉功能和外观。
