Pereira Osvaldo J, Ely Jorge B, Bertelli Jaime A, Vasconcellos Zulmar A, Granemann Alfredo S
From Hospital Florianópolis-Plástica Doctor Clinic, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
Universidade Federal de Santa Catarina, Florianópolis, Brazil.
Plast Reconstr Surg Glob Open. 2024 May 20;12(5):e5805. doi: 10.1097/GOX.0000000000005805. eCollection 2024 May.
This study aimed to demonstrate the clinical application of the dorsoproximal interphalangeal island flap as an alternative approach to skin graft or cross-finger flap to repair lesions at the ventral site at the proximal interphalangeal (PIP) finger joint.
Fifteen patients received flaps (11 men and four women, n = 25 flaps). The repair of volar contracture in finger sequelae after burn injuries was the main indication. Five patients underwent two or more flaps during the same surgical session. The mean patient age was 18 years (range, 7-56 years). Most patients presented with palmar finger contractures of the PIP joint. In three patients, six flaps were rotated to the lateral radial and ulnar proximal surfaces of the finger to treat syndactyly.
Most flaps survived and provided satisfactory functional and aesthetic improvement of palmar scar contracture in the PIP region. Postoperative donor site follow-up was normal. The color and pliability of the skin are similar to those of the surrounding area. The follow-up period ranged from 6 months to 12 years.
Dorsoproximal interphalangeal island flaps are an option for repairing lesions that lack soft tissue and range in size from 10 × 15 to 12 × 18 mm at the volar site and around the PIP joint. The arch of rotation of this flap allows for lateral, ulnar, and radial rotations around the joint. The indication of six flaps in three patients to repair a proximal lack of tissue caused by syndactyly demonstrated its potential use in this anomaly.
本研究旨在证明近节指间背侧岛状皮瓣可作为皮肤移植或邻指皮瓣的替代方法，用于修复近节指间（PIP）关节掌侧部位的损伤。
15例患者接受了皮瓣移植（11例男性，4例女性，共25个皮瓣）。烧伤后手指后遗症掌侧挛缩的修复是主要适应证。5例患者在同一手术过程中接受了两个或更多皮瓣移植。患者的平均年龄为18岁（范围7 - 56岁）。大多数患者表现为PIP关节掌侧手指挛缩。3例患者中，6个皮瓣旋转至手指桡侧和尺侧近端表面以治疗并指畸形。
大多数皮瓣存活，PIP区域掌侧瘢痕挛缩在功能和美观方面均得到满意改善。术后供区随访正常。皮肤颜色和柔韧性与周围区域相似。随访期为6个月至12年。
近节指间背侧岛状皮瓣是修复掌侧部位及PIP关节周围软组织缺损、大小在10×15至12×18mm的损伤的一种选择。该皮瓣的旋转弧允许围绕关节进行桡侧、尺侧和外侧旋转。3例患者中使用6个皮瓣修复并指畸形导致的近端组织缺损，证明了其在这种畸形中的潜在应用价值。
