From the Department of Orthopedic Surgery, the 908th Hospital of the Chinese People's Liberation Army Joint Logistics Support Forces, Nanchang, PR China.
Ann Plast Surg. 2022 Apr 1;88(4):395-400. doi: 10.1097/SAP.0000000000002967.
This retrospective study aimed to compare the clinical effects of reverse digital artery island flaps and antegrade homodigital neurovascular island flaps in fingertip reconstruction.
We retrospectively analyzed the data of 30 consecutive patients with fingertip defects who had undergone 2 types of surgery from January 2016 to January 2019. We used reverse digital artery island flaps and antegrade homodigital neurovascular island flaps in 14 and 16 patients, respectively. Flap sensitivity was evaluated using the Semmes-Weinstein monofilament test and static 2-point discrimination test. Finger appearance was assessed using the Michigan Hand Outcomes Questionnaire. The operation time, flap sensitivity, range of motion of the interphalangeal joint, and complications were evaluated.
The static 2-point discrimination results of the fingers were significantly different between the antegrade homodigital neurovascular island flap group and reverse digital artery island flap group (8.07 ± 1.54 vs 5.94 ± 1.73; P < 0.05). The appearance of the fingers was significantly better in the antegrade homodigital neurovascular island flap group. Surgery using antegrade homodigital neurovascular island flaps required less time than surgery using reverse digital artery island flaps. No significant differences were found between the 2 groups in the range of motion of the interphalangeal joint or complications.
The functional outcomes were identical between the reverse digital artery island flap and antegrade homodigital neurovascular island flap methods for fingertip reconstruction. Antegrade homodigital neurovascular island flaps lead to a shorter operation time, a more satisfying appearance, and better sensory recovery.
本回顾性研究旨在比较逆行指动脉岛状皮瓣和顺行同指指神经血管岛状皮瓣在指尖重建中的临床效果。
我们回顾性分析了 2016 年 1 月至 2019 年 1 月期间连续 30 例接受 2 种手术治疗的指尖缺损患者的数据。我们分别采用逆行指动脉岛状皮瓣和顺行同指指神经血管岛状皮瓣治疗 14 例和 16 例患者。使用 Semmes-Weinstein 单丝试验和静态 2 点辨别试验评估皮瓣敏感性。使用密歇根手功能问卷评估手指外观。评估手术时间、皮瓣敏感性、指间关节活动度和并发症。
顺行同指指神经血管岛状皮瓣组和逆行指动脉岛状皮瓣组手指静态 2 点辨别试验结果差异有统计学意义（8.07±1.54 比 5.94±1.73；P<0.05）。顺行同指指神经血管岛状皮瓣组手指外观明显更好。顺行同指指神经血管岛状皮瓣组手术时间明显短于逆行指动脉岛状皮瓣组。2 组指间关节活动度和并发症差异无统计学意义。
逆行指动脉岛状皮瓣和顺行同指指神经血管岛状皮瓣方法用于指尖重建的功能结果相同。顺行同指指神经血管岛状皮瓣导致手术时间更短、外观更满意、感觉恢复更好。
