Kunming Medical University, Kunming, 650500, Yunnan, China.
Department of Orthopedic Surgery, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, The Key Laboratory of Digital Orthopaedics of Yunnan Provincial, Yunnan Lvweijia Expert Workstation, Kunming, 650034, China.
J Orthop Surg Res. 2023 Sep 13;18(1):682. doi: 10.1186/s13018-023-04156-y.
Soft tissue defects in the hand may result from trauma, oncological procedures, or severe infections. This study aimed to introduce an innovative method for repairing soft tissue defects on the palmar side of the distal segment of the affected finger or fingertip. We explored this surgical method and its curative effect on the volar rotation pedicled flap base on a perforator of the palmar digital artery (VRPF-PPDA) for repairing ventral or fingertip soft tissue defects of the distal segment of the affected finger without impairing its main blood vessels.
Between June 2019 and January 2021, 13 patients with finger pulp or fingertip soft tissue defects were treated with VRPF-PPDA. Flap survival rate, complication rate, two-point discrimination (2PD), and patient satisfaction were used to evaluate the efficacy of this method. The function of the affected finger was evaluated using the upper limb function evaluation method issued by the Trial Standards for Evaluation of Partial Function of the Upper Extremity of the Chinese Society for Surgery of the Hand of the Chinese Medical Association (CMA) and the Disabilities of the Arm, Shoulder, and Head (DASH) score, 6-12 months after the flap-based operation.
Thirteen patients (18 fingers) achieved complete flap survival. The finger pulp flap was full, and no complications occurred. 2PD checks of the flaps revealed that all of them were 4-10 mm in length. According to the Trial Standards for Evaluation of Partial Function of the Upper Extremity of the Chinese Society for Surgery of the Hand of the CMA, hand function was excellent in 12 patients (17 fingers) and good in one patient, with a mean DASH score of 26.05 ± 0.45. Eleven patients selected "excellent" on the subjective satisfaction survey, while the other two selected "good."
VRPF-PPDA surgery is a simple, effective, minimally invasive, and reliable method for repairing soft tissue defects in the distal finger pulp or fingertips. Optimal esthetic reconstruction and anatomical and functional repair can be achieved in fingers repaired using the VRPF-PPDA surgical approach.
手部软组织缺损可由创伤、肿瘤学程序或严重感染引起。本研究旨在介绍一种修复受影响手指或指尖远端节掌侧软组织缺损的创新方法。我们探讨了这种手术方法及其治疗效果，即基于掌侧指动脉穿支（VRPF-PPDA）的旋前旋转皮瓣基底，修复受影响手指远端节的掌侧或指尖软组织缺损，而不损伤其主要血管。
2019 年 6 月至 2021 年 1 月，采用 VRPF-PPDA 治疗 13 例手指指腹或指尖软组织缺损患者。采用皮瓣成活率、并发症发生率、两点辨别觉（2PD）和患者满意度评估该方法的疗效。采用中国医师协会手外科医师分会上肢部分功能评定试用标准和残疾程度量表（DASH）评分，对皮瓣术后 6-12 个月患者的患指功能进行评价。
13 例患者（18 指）皮瓣完全成活，指腹皮瓣饱满，无并发症发生。皮瓣 2PD 检查均为 4-10mm。采用中国医师协会手外科医师分会上肢部分功能评定试用标准评定，手功能优 12 例（17 指），良 1 例，DASH 评分均值为 26.05±0.45。11 例患者在主观满意度调查中选择“优”，2 例选择“良”。
VRPF-PPDA 手术是修复手指远端指腹或指尖软组织缺损的一种简单、有效、微创、可靠的方法。采用 VRPF-PPDA 手术修复的手指可实现最佳的美学重建和解剖及功能修复。
