Imaizumi Atsushi, Kadota Hideki
Department of Plastic Surgery, Okinawa Prefectural Chubu Hospital, Uruma, Japan.
Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan.
J Plast Reconstr Surg. 2022 Jan 27;1(1):11-19. doi: 10.53045/jprs.2021-0002.
Fingertip injuries are common, and there are many techniques used for reconstruction. The authors reviewed the outcomes of fingertip reconstruction, including sensation and shape, using the combined technique of the adipofascial cross-finger flap and glabrous skin graft and defined the optimal dimensions of fingertip defect that is applicable to this technique.
Between 2006 and 2016, 10 cases, aged 3-60 years (mean, 28.1 years), who had undergone fingertip reconstruction using a combination of the adipofascial cross-finger flap and glabrous skin graft were reviewed. The presence of fingertip and nail deformity and the results of the Semmes-Weinstein monofilament and static two-point discrimination tests were analyzed.
Fingertip deformity was noted in three cases where the defect was more than 50% of the Tamai zone I or extended to zone II. Mild nail plate deformity was found in three cases with more than 40% of the nail bed defect. Two of these three cases presented with partial phalangeal tuft defects. Eight fingers were examined using the Semmes-Weinstein test, and their scores were between 2.83 and 4.31 in five fingers and 4.56 in three fingers. Six were examined for static two-point discrimination, with 5 mm in three, 6 mm in one, and 10 mm in two. The color and contour of all donor fingers were almost typical.
The combination of the adipofascial cross-finger flap and full-thickness glabrous skin graft is applicable to around 50% of fingertip defect within the Tamai zone I, achieving a satisfactory shape and regaining more than protective sensation.
指尖损伤很常见，用于重建的技术有很多。作者回顾了采用脂肪筋膜交叉手指皮瓣和无毛皮肤移植联合技术进行指尖重建的结果，包括感觉和外形，并确定了适用于该技术的指尖缺损最佳尺寸。
回顾2006年至2016年间10例年龄在3至60岁（平均28.1岁）的患者，他们采用脂肪筋膜交叉手指皮瓣和无毛皮肤移植联合技术进行了指尖重建。分析指尖和指甲畸形的情况以及Semmes-Weinstein单丝试验和静态两点辨别试验的结果。
在3例缺损超过玉井I区50%或延伸至II区的病例中发现了指尖畸形。在3例甲床缺损超过40%的病例中发现了轻度指甲板畸形。这3例中的2例伴有部分指骨粗隆缺损。对8根手指进行了Semmes-Weinstein试验，其中5根手指的评分在2.83至4.31之间，3根手指的评分为4.56。对6根手指进行了静态两点辨别试验，其中3根为5毫米，1根为6毫米，2根为10毫米。所有供指的颜色和轮廓几乎正常。
脂肪筋膜交叉手指皮瓣和全厚无毛皮肤移植联合技术适用于玉井I区内约50%的指尖缺损，可获得满意的外形并恢复超过保护性感觉的感觉。
