Russell R C, Van Beek A L, Wavak P, Zook E G
J Hand Surg Am. 1981 Jul;6(4):399-405. doi: 10.1016/s0363-5023(81)80053-6.
Traumatic or thermal injury to the hand may result in a composite tissue loss. Exposed tendon, bone, or joint surface is best treated by flap coverage. This paper will discuss four types of alternative hand flaps that can be used to treat difficult areas and/or minimize complications. (1) A thumb flap elevated from the metacarpophalangeal joint flexion crease covers a fingertip injury and the donor site is closed primarily. (2) A proximally based side-finger flap, preferably from the ulnar side of the donor finger, can be used to cover a fingertip defect in a young person or a thumb tip in any age. (3) A deepithelized cross-finger flap, flipped 180 degrees upside-down, can cover a defect on an adjacent finger. The under side of the flap and the donor area are skin grafted. (4) A proximally based arterialized side-finger flap, including the digital artery but sparing the digital nerve, is rotated dorsally to cover a secondarily exposed proximal interphalangeal joint in burn patients where adjacent fingers are not available as donor sites.
手部的创伤或热损伤可能导致复合组织缺损。暴露的肌腱、骨骼或关节面最好通过皮瓣覆盖来治疗。本文将讨论四种可用于治疗手部难处理区域和/或减少并发症的替代性皮瓣。（1）从掌指关节屈曲皱襞掀起的拇指皮瓣可覆盖指尖损伤，供区可直接缝合。（2）以近端为蒂的侧指皮瓣，最好取自供指的尺侧，可用于覆盖年轻人的指尖缺损或任何年龄的拇指尖缺损。（3）去上皮的交叉指皮瓣翻转180度后可覆盖相邻手指的缺损。皮瓣的底面和供区进行植皮。（4）以近端为蒂的动脉化侧指皮瓣，包括指动脉但保留指神经，向背侧旋转以覆盖烧伤患者中继发暴露的近端指间关节，此时相邻手指不可作为供区。
