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指背筋膜岛状皮瓣联合邻指皮瓣修复手指末节脱套伤及感觉重建的临床效果

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction.

作者信息

Hao Ruizheng, Huo Yongxin, Wang Hui, Liu Wei

机构信息

The Department of Hand Surgery, The Second Hospital of Tangshan, Tangshan, China.

出版信息

Front Surg. 2022 Jan 17;8:732597. doi: 10.3389/fsurg.2021.732597. eCollection 2021.

Abstract

BACKGROUND

To explore the clinical effect of digital dorsal fascial island flap combined with crossfinger flap to repair distal degloving injury and sensory reconstruction.

METHODS

A total of 19 patients with distal fingertip degloving injuries treated with digital dorsal fascial island flap combined with crossfinger flap in our hospital from April 2018 to August 2020 were retrospectively included. Semmes-Weinstein (SW) monofilament and static two-point discrimination (S-2PD) tests, active range-of-motion (ROM) of the fingers, cold intolerance, visual analog scale (VAS) score patient complications, and patient satisfaction were evaluated.

RESULTS

Five cases with post-operative flap blisters were treated at the time of dressing changes until successful scab formation. Three cases with post-operative arterial crisis of finger arterial dorsal branch vessel were relieved after suture removal and tension reduction. All other skin flaps and skin grafts survived. Nineteen patients received follow-up between 3 and 26 months (average 14.6 months). The active ROM of metacarpophalangeal (MCP) and interphalangeal (IP) joints of the injured fingers were satisfactory.

CONCLUSION

The digital dorsal fascial island flap combined with the crossfinger flap for repairing the distal degloving injury of the distal segment of the finger is a good surgical method, which is simple and easy to operate, can repair a large area of soft tissue defect, and obtain a satisfactory effect.

摘要

背景

探讨指背筋膜岛状皮瓣联合邻指皮瓣修复手指末节脱套伤及感觉重建的临床效果。

方法

回顾性纳入2018年4月至2020年8月在我院采用指背筋膜岛状皮瓣联合邻指皮瓣治疗的19例手指末节脱套伤患者。评估Semmes-Weinstein(SW)单丝试验和静态两点辨别觉(S-2PD)测试、手指主动活动范围(ROM)、冷不耐受情况、视觉模拟量表(VAS)评分、患者并发症及患者满意度。

结果

5例术后皮瓣出现水泡,在换药时处理至结痂成功。3例术后手指动脉背侧支血管发生动脉危象,经拆除缝线、减轻张力后缓解。其余皮瓣及植皮均成活。19例患者获得3至26个月(平均14.6个月)的随访。伤指掌指关节(MCP)和指间关节(IP)的主动活动范围满意。

结论

指背筋膜岛状皮瓣联合邻指皮瓣修复手指末节远段脱套伤是一种较好的手术方法,操作简便,能修复大面积软组织缺损,且效果满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce0f/8801504/42f2d00f00c6/fsurg-08-732597-g0001.jpg

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