Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, Shenyang, China.
Department of Oral Implant, Guangdong Engineering Research of Oral Restoration and reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China.
Head Neck. 2022 Oct;44(10):2142-2150. doi: 10.1002/hed.27124. Epub 2022 Jun 21.
There is a shortage of well-designed self-controlled studies evaluating hand biomechanics following ulnar forearm flap (UFF) harvest. This study was conducted to evaluate objective and subjective functional outcomes of the donor's hand following UFF harvest.
All patients undergoing UFF were included for analysis. Grip strength, wrist movement, forearm supination and pronation, pinch strengths, sensation to light touch and temperature, and hand dexterity were assessed preoperatively and at 1, 3, and 6 months postoperatively. In addition, DASH score (disabilities of the arm, shoulder, and hand score) and Patient and Observer Scar Assessment Scale (POSAS) were analyzed.
A total of 18 patients were enrolled. A significant reduction in grip strength for donor's hand was observed between preoperative and postoperative 1 and 3 months (mean difference = 14 kg, 7.38 kg, respectively, p = 0.000 for all). A similar trend was observed for pinch strength and range of motion (p < 0.05). Three months after surgery, there is still a significant reduction in tip pinch, tripod pinch, wrist extension, and supination. All biomechanics outcomes returned to preoperative baseline at 6 months after surgery. No patients suffered significant changes in sensation to light touch, temperature, and numbness by 6 months. There was a significant increase in DASH score by 3.37 points 6 months after operation (p = 0.000). The POSAS score indicates satisfaction with the appearance of the donor site.
UFF is a safe and reliable option for oral cavity reconstruction with minimum donor site morbidities, mainly when cosmesis is paramount. Furthermore, objective hand biomechanics ultimately returns to its preoperative state within 6 months after surgery.
目前缺乏针对尺骨前臂皮瓣（UFF）采集后手生物力学的精心设计的自控研究。本研究旨在评估 UFF 采集后手的客观和主观功能结果。
所有接受 UFF 的患者均纳入分析。术前和术后 1、3 和 6 个月评估握力、腕部运动、前臂旋前和旋后、捏力、轻触和温度感觉以及手灵巧度。此外，还分析了 DASH 评分（手臂、肩部和手残疾评分）和患者和观察者瘢痕评估量表（POSAS）。
共纳入 18 例患者。与术前相比，术后 1 个月和 3 个月时供手的握力明显下降（平均差值分别为 14kg 和 7.38kg，p 值均为 0.000）。捏力和运动范围也呈现类似趋势（p < 0.05）。术后 3 个月，指尖捏力、三指捏力、腕伸和旋后仍明显下降。术后 6 个月，所有生物力学结果均恢复到术前基线。6 个月时，所有患者的轻触、温度和麻木感觉均无明显变化。术后 6 个月 DASH 评分显著增加 3.37 分（p = 0.000）。POSAS 评分表明供区外观满意度高。
UFF 是口腔重建的一种安全可靠的选择，供区并发症少，当美容效果至关重要时尤其如此。此外，术后 6 个月内，客观手部生物力学最终恢复到术前状态。
