Mulica Markus, Yasmin Mohamed, Cai Aijia, Arkudas Andreas, Müller-Seubert Wibke, Horch Raymund E
Plastische- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Erlangen, Germany.
Handchir Mikrochir Plast Chir. 2024 Dec;56(6):448-453. doi: 10.1055/a-2351-6697. Epub 2024 Jul 15.
Although multiple advances have been made in finger defect reconstruction, cross-finger flaps remain an important reconstructive tool. However, data on long-term results are scarce in the literature. This study aimed to assess the clinical and subjective long-term outcomes of patients who underwent cross-finger flap reconstruction for palmar digital and fingertip defects.
Between January 2003 and July 2022, 35 patients (31 male, 4 female, mean age: 59.0 years±20.1) were screened and included in the study. The data were obtained through a clinical examination, a Quick-DASH score and a self-designed questionnaire. Clinical outcomes were assessed by evaluating the range of motion (ROM) of the reconstructed finger and the donor finger compared with the contralateral uninjured hand. In addition to ROM, a static two-point separation test was performed to assess the sensory function of the reconstructed finger. The follow-up period was between 1 year and 19 years (mean: 12.6 years±6.1).
There was no significant difference in terms of ROM between the reconstructed finger and the donor finger compared with the contralateral uninjured hand. All patients reported normal discrimination between sharp and blunt objects. However, there was a significant difference in two-point discrimination between the reconstructed finger and the healthy contralateral finger (p<0.05). The average Quick-DASH score was 5.1 points. Satisfaction with the functional outcome in terms of mobility and load-bearing capacity of the cross-finger flap averaged 8.1 out of 10 points. Satisfaction with the aesthetic outcome of the reconstructed finger averaged 7.7 out of 10 points. In 4 cases, persistent pain was reported when the reconstructed finger was under stress. No cases of pain at rest were reported.
In the long run, cross-finger flaps are a safe and effective reconstructive procedure for covering defects in palmar injuries of the finger and fingertip amputation. They represent a simple, reliable, long-lasting reconstructive technique. The necessary temporary iatrogenic syndactyly does not lead to long-term limitations in the range of motion.
尽管手指缺损重建已取得多项进展，但交指皮瓣仍是一种重要的重建工具。然而，文献中关于长期结果的数据很少。本研究旨在评估因手掌部手指和指尖缺损接受交指皮瓣重建的患者的临床和主观长期结果。
2003年1月至2022年7月期间，筛选出35例患者（31例男性，4例女性，平均年龄：59.0岁±20.1）纳入研究。数据通过临床检查、Quick-DASH评分和自行设计的问卷获得。通过评估重建手指和供指与对侧未受伤手相比的活动范围（ROM）来评估临床结果。除ROM外，还进行了静态两点辨别试验以评估重建手指的感觉功能。随访期为1年至19年（平均：12.6年±6.1）。
与对侧未受伤手相比，重建手指和供指在ROM方面无显著差异。所有患者均报告对锐器和钝器的辨别正常。然而，重建手指与对侧健康手指之间的两点辨别存在显著差异（p<0.05）。Quick-DASH平均评分为5.1分。对交指皮瓣在活动度和承重能力方面的功能结果满意度平均为8.1分（满分10分）。对重建手指美学结果的满意度平均为7.7分（满分10分）。4例患者报告重建手指受压时持续疼痛。未报告静息痛病例。
从长远来看，交指皮瓣是覆盖手指掌侧损伤和指尖离断缺损的一种安全有效的重建方法。它们代表了一种简单、可靠、持久的重建技术。必要的临时性医源性并指不会导致活动范围的长期受限。
