Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
J Plast Surg Hand Surg. 2023 Jun 14;58:18-23. doi: 10.2340/jphs.v58.11967.
Homodigital dorsal branch of proper digital artery flaps (HDBPDAF) have been proved to be an excellent alternative for repairing distal soft tissue defects of fingertip. This study was to evaluate the clinical effects of HDBPDAF on repairing various soft tissue defects of fingers, including thumb and multi-fingers defects. A retrospective study was conducted in 40 patients with 44 finger defects treated with HDBPDAF from August of 2014 to December of 2021. The defects were located on fingertip and finger pulp (n = 28), finger pulp (n = 10), and dorsum of fingers (n = 6) with bone, tendon or nerve exposed. The average size of the flaps was 1.9 × 3.9 cm. Semmes Weinstein monofilament (SWM) test, Static two-point discrimination (2-PD), Total active motion (TAM) scores, the mean Disabilities of the Arm, Shoulder, and Hand (DASH) score were evaluated through long-term follow-up. Forty-two flaps survived completely and uneventfully. Partial flap necrosis was observed in two flaps because of the absence of dorsal branch of proper digital artery. No visible scar contracture and joint limitation were noticed. The mean SWM score of flaps was 4.11 ± 0.4 g. The average 2-PD of the flaps was 8.9 ± 0.9 mm. The mean TAM of injured fingers was 268.7 ± 5.2° (contralateral side: 283.2 ± 6.4°, p < 0.05). The mean DASH score value was 29.7 ± 7.9. The HDBPDAF was an optimal and reliable alternative to repair various distal soft tissue defects of fingers, despite a lower absent rate of dorsal branch.
同指指背动脉皮支逆行岛状皮瓣修复指尖部各种软组织缺损的临床效果研究 同指指背动脉皮支逆行岛状皮瓣（HDBPDAF）已被证实是修复指尖部远端软组织缺损的一种极好的选择。本研究旨在评估 HDBPDAF 修复各种手指（包括拇指和多指）软组织缺损的临床效果。回顾性分析 2014 年 8 月至 2021 年 12 月采用 HDBPDAF 治疗的 40 例 44 指手指缺损患者的临床资料。缺损位于指尖和指腹（n = 28）、指腹（n = 10）和手指背侧（n = 6），伴有骨、肌腱或神经外露。皮瓣平均大小为 1.9×3.9cm。通过长期随访评估 Semmes-Weinstein 单丝（SWM）试验、静态两点辨别觉（2-PD）、总主动活动度（TAM）评分、上肢残疾问卷（DASH）评分。42 例皮瓣完全成活，无并发症。2 例皮瓣因指固有动脉背侧支缺如而出现部分坏死。未见明显的瘢痕挛缩和关节受限。皮瓣的平均 SWM 评分为 4.11 ± 0.4g。皮瓣的平均 2-PD 为 8.9 ± 0.9mm。患指 TAM 平均为 268.7 ± 5.2°（对侧：283.2 ± 6.4°，p < 0.05）。DASH 评分平均为 29.7 ± 7.9。HDBPDAF 是修复各种手指远端软组织缺损的一种理想且可靠的选择，尽管背侧支的缺失率略高。
