Cottier Célina, Durand Sébastien
Department of Hand Surgery, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 5, 1011 Lausanne, Switzerland.
JPRAS Open. 2025 Apr 13;44:424-429. doi: 10.1016/j.jpra.2025.04.004. eCollection 2025 Jun.
Reconstructing multi-tissue defects in the finger remains a significant challenge in hand surgery. We present the case of a 37-year-old man with segmental loss of bone, skin and extensor apparatus on the dorsal aspect of the index finger. A single stage reconstruction was successfully performed using a pedicled chimeric flap based on the second dorsal metacarpal artery combining skin paddle, second metacarpal base bone and the extensor indicis proprius. At 12 weeks, proximal interphalangeal joint fusion was achieved and the skin flap healed uneventfully. The patient regained full extension and 20° of active flexion at the distal interphalangeal joint. To our knowledge, this specific chimeric flap has not been previously described in the literature. This technique provides a versatile, single-stage solution for complex dorsal finger reconstruction, minimizing morbidity and optimizing functional outcomes.
重建手指的多组织缺损仍是手部外科的一项重大挑战。我们报告一例37岁男性患者，其示指背侧存在骨、皮肤和伸肌装置的节段性缺失。基于第二掌背动脉采用带蒂嵌合皮瓣，联合皮瓣、第二掌骨基底骨和示指固有伸肌，成功进行了一期重建。术后12周，近端指间关节实现融合，皮瓣愈合良好。患者远侧指间关节恢复了完全伸直，主动屈曲达20°。据我们所知，这种特定的嵌合皮瓣此前在文献中尚未见报道。该技术为复杂的手指背侧重建提供了一种通用的一期解决方案，可将发病率降至最低，并优化功能结局。
