University of Medipol, School of Medicine, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
Private Office, Diyarbakır, Turkey.
J Orthop Sci. 2024 Sep;29(5):1203-1207. doi: 10.1016/j.jos.2023.08.012. Epub 2023 Oct 13.
Antegrade homodigital neurovascular island flap (AHIF) is one of the methods used in fingertip amputations to cover the defect area, preserve finger length and obtain a painless and sensitive fingertip. The aim of this study was to evaluate the functional and sensory outcomes in patients who underwent AHIF for fingertip amputation and to analyze the relationship between patient satisfaction and outcome measures.
Twenty patients with a mean age of 37 (18-63) years were analyzed retrospectively. The patients were evaluated in terms of hook nail development, active interphalangeal joint movements, cold intolerance, and sensory function of the flap covered area. Static two-point discrimination test and Semmes Weinstein monofilament test were performed for sensory evaluation.
All flaps survived completely at the end of follow-up (mean, 36 months; range 11-64 months). Five patients had cold intolerance and two had hook nails. In total, proximal interphalangeal or distal interphalangeal joint flexion contracture developed in 25 % of the patients. The mean static two-point discrimination score was 4.6 ± 1.6 (2-8) and Semmes-Weinstein monofilament test score was 3.48 ± 0.6 (2.44-4.17). Subjective satisfaction levels of the patients were found to be high and did not show a statistical relationship with the measured clinical outcome parameters (p > 0.05).
Since AHIF contains a solid and continuous neurovascular pedicle, the probability of necrosis and loss of sensation is low in AHIF. In addition, the graft need of the donor area is not high. Its disadvantage is the rate of restriction of joint movements.
IV.
逆行指动脉岛状皮瓣（AHIF）是指尖离断伤中用于覆盖缺损区、保留指长和获得无痛敏感指尖的方法之一。本研究旨在评估接受 AHIF 治疗指尖离断伤的患者的功能和感觉结果，并分析患者满意度与结果测量之间的关系。
回顾性分析 20 例患者，平均年龄 37 岁（18-63 岁）。评估患者钩甲形成、指间关节主动活动度、耐寒性以及皮瓣覆盖区域的感觉功能。采用静态两点辨别试验和 Semmes-Weinstein 单丝试验进行感觉评估。
所有皮瓣在随访结束时（平均 36 个月；范围 11-64 个月）均完全存活。5 例患者有耐寒性差，2 例有钩甲。共有 25%的患者出现近节指间关节或远节指间关节屈曲挛缩。平均静态两点辨别试验评分为 4.6±1.6（2-8），Semmes-Weinstein 单丝试验评分为 3.48±0.6（2.44-4.17）。患者的主观满意度水平较高，与测量的临床结果参数无统计学关系（p>0.05）。
由于 AHIF 包含一个坚实且连续的血管神经蒂，因此 AHIF 发生坏死和感觉丧失的概率较低。此外，供区的移植物需求不高。其缺点是关节活动受限的发生率较高。
IV 级。
