Christen Thierry, Cottier Célina, Durand Sébastien
Department of Plastic and Hand Surgery, Centre Hospitalier Universitaire Vaudois, 1005 Lausanne, Switzerland.
J Clin Med. 2024 Jul 19;13(14):4214. doi: 10.3390/jcm13144214.
Vascularized bone grafts of the wrist and hand help to achieve bone union in various clinical settings such as bone fusion or nonunion treatment. Among the multiple possible donor sites, the base of the second metacarpal is convenient because of its relatively straightforward harvesting, lack of impairment of the hand vascularization, sufficient bone supply for small joint fusion and phalanx or metacarpal nonunion management. The flap is versatile as it can reach any carpal and metacarpal bone as well as the proximal phalanx of all fingers. The arc of rotation of the flap depends on which side of the dorsal intercarpal arch it is based, either radially or ulnarly. It can also be pedicled distally by a retrograde flow through the second dorsal metacarpal artery. The robust vascularization of the flap allows for reliable healing. We present five new indications in various clinical settings that illustrate the versatility of the arc of rotation of the flap.
腕部和手部的带血管蒂骨移植有助于在多种临床情况下实现骨愈合，如骨融合或骨不连的治疗。在多个可能的供区中，第二掌骨基部很方便，因为其切取相对简单，不会损害手部血运，有足够的骨量用于小关节融合以及指骨或掌骨骨不连的处理。该皮瓣用途广泛，可到达任何腕骨和掌骨以及所有手指的近节指骨。皮瓣的旋转弧取决于其基于背侧腕骨弓的哪一侧，即桡侧或尺侧。它也可以通过逆行血流经第二掌背动脉向远端带蒂。皮瓣强大的血运有利于可靠愈合。我们展示了在各种临床情况下的五个新适应证，以说明皮瓣旋转弧的多功能性。
