Department of Hand Surgery, Wuxi No. 9 People's Hospital affiliated to Soochow University, Wuxi Hand Surgery Hospital, Wuxi, Jiangsu, People's Republic of China.
J Orthop Surg (Hong Kong). 2022 May-Aug;30(2):23094990211025089. doi: 10.1177/23094990211025089.
To assess the clinical value and feasibility of the dorsoulnar flap of the thumb combined with relay V-Y flaps for reconstruction of the thumb fingertip injuries.
In this retrospective study, we retrospectively reviewed 20 patients (13 men, 7 women; June 2014-June 2016) with thumb fingertip defects who underwent reconstructive procedures with transfer of the dorsoulnar flap of the thumb. The average size of the defects ranged from 1.8 cm × 2.0 cm to 2.0 cm × 3.0 cm, whereas the reconstructed dorsoulnar flap of the thumb ranged in size from 2.0 cm × 2.2 cm to 2.2 cm × 3.0 cm. A V-Y flap was used to repair the donor site at the same time. Sensation within the reconstructed thumb, the aesthetic appearance of both the donor and recipient sites, functional recovery, and return-to-work (RTW) time were measured.
All 40 flaps survived without necrosis. The follow-up period ranged from 6 to 24 months. There were no complications reported. The mean static two-point discrimination values at the reconstructed thumb fingertip and donor site were 8.5 mm (range 8-10 mm) and 12.5 mm (range 12-14 mm), respectively. The average visual analog scores for the aesthetic appearance of the recipient and donor sites were 8.4 (range 8-9.5) and 9.6 (range 9-10), respectively. The average Michigan Hand Outcome Questionnaire score for the reconstructed hand was 9.4 (range 6-16). The average RTW time was 9.8 weeks (range 6-13 weeks). All patients were satisfied with the aesthetic outcome.
The dorsoulnar flap of the thumb is an ideal alternative for reconstruction of the thumb fingertip injuries, and a V-Y flap was suitable for repairing the donor site with a reduced incidence of complications.
评估拇指背侧皮瓣联合接力 V-Y 皮瓣重建拇指指尖损伤的临床价值和可行性。
在这项回顾性研究中，我们回顾性分析了 20 例（13 名男性，7 名女性；2014 年 6 月至 2016 年 6 月）接受拇指背侧皮瓣转移重建拇指指尖缺损的患者。缺损的平均大小为 1.8cm×2.0cm 至 2.0cm×3.0cm，而重建的拇指背侧皮瓣大小为 2.0cm×2.2cm 至 2.2cm×3.0cm。同时使用 V-Y 皮瓣修复供区。测量重建拇指的感觉、供区和受区的美学外观、功能恢复和重返工作岗位（RTW）时间。
所有 40 个皮瓣均未发生坏死。随访时间为 6 至 24 个月。无并发症发生。重建拇指指尖和供区的平均静态两点辨别觉值分别为 8.5mm（8-10mm）和 12.5mm（12-14mm）。供区和受区美学外观的平均视觉模拟评分分别为 8.4（8-9.5）和 9.6（9-10）。重建手的密歇根手功能问卷评分平均为 9.4（6-16）。平均 RTW 时间为 9.8 周（6-13 周）。所有患者对美学效果均满意。
拇指背侧皮瓣是重建拇指指尖损伤的理想选择，V-Y 皮瓣适合修复供区，并发症发生率较低。
