Qingdao Hospital, University of Health and Rehabilitation Science (Qingdao Municipal Hospital), Qingdao, 266011, Shandong, China.
Changchun University of Traditional Chinese Medicine, Changchun, Jilin, 130117, China.
BMC Surg. 2023 Aug 11;23(1):231. doi: 10.1186/s12893-023-02097-1.
How to reconstruct the damaged fingertip is a clinical problem. Our team propose the theory of equivalent design and use the mini toenail flap pedicled with the hallux transverse artery and toe pulp vein transplantation technique to reconstruct Allen's type II fingertip injury. Thus, we perform the retrospective study to evaluate the effects of this technique on fingertip injury.
A retrospective analysis was performed on 56 patients admitted to our hospital from January 2015 to January 2020 who used equivalently designed miniature hallux toenail flaps for the plastic repair of fingertip damage. We recorded the size of the miniature hallux toenail flap, operation time, intraoperative blood loss, and complications and calculated the survival rate of the transplanted miniature hallux toenail flap. During routine follow-up after surgery, we recorded nail growth time and observed finger appearance. At the last time of follow-up, we recorded Semmes-Weinstein evaluating tactile sensation and Two-point discrimination testing (TPD). The efficacy was evaluated by Zook score evaluation.
The size of the mini hallux toenail flap was 0.71 cm × 1.22 cm to 0.88 cm × 1.71 cm. The operation time was (3.54 ± 0.58) hours, the intraoperative blood loss was (20.66 ± 4.87) ml, and the survival rate of mini hallux toenail flaps was 100%. The postoperative follow-up time was (30.82 ± 11.21) months, and the total nail growth time was (9.68 ± 2.11) months. The average tactile sensation evaluated by the Semmes-Weinstein test was (0.32 ± 0.14) g, and the average TPD was (7.33 ± 1.02) mm. According to Zook score, the curative effect of fifty-six cases were all excellent or good with 100% excellent and good rate, and all patients had beautiful appearances and good function of damaged fingertips.
Based on the equivalent design theory, the mini hallux toenail flap pedicled with the hallux transverse artery and toe pulp vein transplantation technique is an effective method to reconstruct Allen's type II fingertip injury with a beautiful appearance and good function.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
如何重建受损的指尖是一个临床问题。我们的团队提出了等效设计理论，并使用带有踇趾横动脉和趾腹静脉的微型趾甲瓣移植技术来重建 Allen Ⅱ型指尖损伤。因此，我们进行了回顾性研究来评估该技术对指尖损伤的效果。
对 2015 年 1 月至 2020 年 1 月我院收治的 56 例使用等效设计的微型踇趾甲瓣进行整形修复指尖损伤的患者进行回顾性分析。我们记录了微型踇趾甲瓣的大小、手术时间、术中失血量、并发症，并计算了移植微型踇趾甲瓣的成活率。术后常规随访时记录指甲生长时间，观察手指外观。末次随访时，记录 Semmes-Weinstein 触觉评估和两点辨别测试（TPD）。采用 Zook 评分评估疗效。
微型踇趾甲瓣的大小为 0.71 cm×1.22 cm 至 0.88 cm×1.71 cm。手术时间为（3.54±0.58）小时，术中出血量为（20.66±4.87）ml，微型踇趾甲瓣成活率为 100%。术后随访时间为（30.82±11.21）个月，总指甲生长时间为（9.68±2.11）个月。Semmes-Weinstein 试验评估的平均触觉为（0.32±0.14）g，平均 TPD 为（7.33±1.02）mm。根据 Zook 评分，56 例疗效均为优或良，优良率为 100%，所有患者均有美观的外观和良好的受损指尖功能。
基于等效设计理论，采用带有踇趾横动脉和趾腹静脉的微型趾甲瓣移植技术是重建 Allen Ⅱ型指尖损伤的有效方法，具有良好的外观和功能。
研究类型/证据水平：治疗性 IV 级。
