Jung Soyeon, Yi Sodam, Lee Seungjun, Eun Seokchan
Department of Plastic and Reconstructive Surgery, Hallym University College of Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea.
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea.
J Clin Med. 2025 Aug 19;14(16):5855. doi: 10.3390/jcm14165855.
Varioaus methods are available to address fingertip injuries, which are becoming increasingly common. Coverage should ideally involve both functional and aesthetic improvements. The second toe pulp-free flap is useful because of its similarity to the fingertips in shape, texture, and sensation. Herein, we present our clinical experience and surgical methods for fingertip defect reconstruction using second toe pulp-free flaps. Between April 2022 and May 2023, 13 toe pulp-free flaps were used to reconstruct fingertip defects. The average patient age was 50.1 years (range, 35-67 years), and nine of the 13 patients were male. Nine patients were injured on the right hand, and four on the left hand. After complete debridement, a toe-pulp flap was harvested with a teardrop from the ipsilateral side. The cases included the reconstruction of four index fingers, seven middle fingers, and two little fingers. Functional and aesthetic assessments were performed postoperatively. All flaps survived completely, with no partial necrosis. The average flap size was 1.5 × 2 cm (range, 0.8 × 1.5 to 2.0 × 3.0 cm). None of the patients had functional impairments. No emergency surgeries were required during the follow-up period. The median follow-up period was 28 months, and the median duration of surgery was 119 min (range, 100-140 min). The average static two-point discrimination score for the injured finger pulp was 3.7 mm (range, 2-5 mm), the Quick Dash score was 3.4 (range, 2.3-4.2), and the Vancouver scar scale was 1.5 (range, 0-2). The toe pulp-free flap is the optimal choice for surgical treatment of fingertip defects and injuries, with excellent functional and cosmetic results.
有多种方法可用于处理越来越常见的指尖损伤。理想情况下，覆盖范围应同时包括功能和美观的改善。第二趾甲床游离皮瓣很有用，因为它在形状、质地和感觉上与指尖相似。在此，我们介绍使用第二趾甲床游离皮瓣重建指尖缺损的临床经验和手术方法。2022年4月至2023年5月期间，13例趾甲床游离皮瓣用于重建指尖缺损。患者平均年龄为50.1岁（范围35 - 67岁），13例患者中有9例为男性。9例患者右手受伤，4例左手受伤。彻底清创后，从同侧切取带泪滴状的趾甲床皮瓣。病例包括重建4例示指、7例中指和2例小指。术后进行功能和美观评估。所有皮瓣均完全存活，无部分坏死。皮瓣平均大小为1.5×2 cm（范围0.8×1.5至2.0×3.0 cm）。所有患者均无功能障碍。随访期间无需急诊手术。中位随访期为28个月，中位手术时间为119分钟（范围100 - 140分钟）。受伤指腹的平均静态两点辨别觉评分为3.7 mm（范围2 - 5 mm），Quick Dash评分为3.4（范围2.3 - 4.2），温哥华瘢痕量表评分为1.5（范围0 - 2）。第二趾甲床游离皮瓣是指尖缺损和损伤手术治疗的最佳选择，功能和美容效果极佳。
