Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine, Soonchunhyang University Gumi Hospital, Gumi 39371, Korea.
Medicina (Kaunas). 2022 Oct 19;58(10):1483. doi: 10.3390/medicina58101483.
Amputation at the level of the distal phalanx is a common hand injury and is normally treated with replantation. However, if the level of injury is distal or the vessels of the stump have been crushed by injury, replantation cannot be a viable option. The aim of this study is to evaluate the functional and aesthetic outcomes of the "hybrid abdominal flap", which consists of a random-pattern abdominal skin flap and an autologous bone graft. A retrospective analysis was performed on fingertip amputation patients from March 2019 to April 2021. The patients were managed by either hybrid abdominal flaps (HAFs) or homodigital neurovascular island flaps (HNIFs). The functional and aesthetic outcomes were assessed three months after the operations. In this study, a total of 20 fingers were treated with either HAFs or HNIFs. There was a significant difference in the range of motion (ROM) and the scar quality between the two groups. All of the flaps survived without flap necrosis, and non-union of the bone was not observed. The patients were satisfied with the appearance and function of their fingers, including the ROM and sensory aspects. Our novel HAF is a functionally and aesthetically valid option for fingertip amputations with crushed stumps.
指尖离断伤是一种常见的手部损伤，通常采用再植术治疗。然而，如果损伤部位在远端，或者残端的血管因损伤而受到挤压，再植术可能不是可行的选择。本研究旨在评估“混合式腹部皮瓣”的功能和美学效果，该皮瓣由随意皮瓣和自体骨移植物组成。回顾性分析了 2019 年 3 月至 2021 年 4 月期间指尖离断伤患者的临床资料。这些患者采用混合式腹部皮瓣（HAFs）或同指指动脉神经岛状皮瓣（HNIFs）治疗。术后 3 个月评估功能和美学效果。本研究共治疗 20 个手指，采用 HAFs 或 HNIFs 治疗。两组间的关节活动度（ROM）和瘢痕质量存在显著差异。所有皮瓣均未发生皮瓣坏死，未观察到骨不连。患者对手指的外观和功能均满意，包括 ROM 和感觉方面。我们的新型 HAF 是一种治疗挤压性残端指尖离断伤的有效方法，具有良好的功能和美学效果。
