Guimberteau J C, Panconi B, Boileau R
Institut Aquitain de la Main, Bordeaux, France.
Ann Chir Plast Esthet. 1994 Jun;39(3):301-17.
Over several years, the authors have devised a technique for compound island transplants of ulnar origin, harvested from the forearm's lower third, with reverse flow vascularization. Because of the variety of arterial ramifications, these transplants can consist: either of a simple cutaneous, superficial flexor tendon or ulnar fragment transplant, or, when associated, of compound cutaneous-tendinous, cutaneous-osseous and even cutaneous-tendinous-osseous transplants. These transplants, based on the clinical experience of 192 cases, can be used by retrograde rotation for a variety of indications, such as loss of skin cover, digital surface reconstruction or treatment of scaphoid pseudoarthrosis. But their main indication, as it represents a basic difference with other retrograde flaps, is the possibility of an island transplant of several superficial flexors complete with sheats, for the reconstruction of the fingers' flexing system in a single surgical act. This is all the more interesting as it is still technically possible to combine it with a cutaneous flap, so that the tendinous and cutaneous problems can be solved simultaneously. This technique permits reconstruction of the fingers' flexor system based on another concept, i.e. by using a vascularized tendinous transplant, and under different conditions since a single surgical act is required, thus saving long periods of sick leave, with functional results which compare with those of traditional techniques.
多年来，作者设计了一种源自尺侧的复合岛状移植技术，取自前臂下三分之一处，并采用逆流血管化。由于动脉分支的多样性，这些移植可以包括：单纯的皮肤、浅屈肌腱或尺侧片段移植，或者在联合时，包括复合皮肤 - 肌腱、皮肤 - 骨甚至皮肤 - 肌腱 - 骨移植。基于192例临床经验，这些移植可通过逆行旋转用于多种适应症，如皮肤覆盖缺失、指面重建或舟状骨假关节的治疗。但其主要适应症，由于它代表了与其他逆行皮瓣的根本区别，是能够进行带有腱鞘的多个浅屈肌的岛状移植，以便在单次手术中重建手指的屈曲系统。这一点尤其有趣，因为在技术上仍然可以将其与皮瓣相结合，从而能够同时解决肌腱和皮肤问题。该技术基于另一种概念，即通过使用血管化肌腱移植来重建手指的屈曲系统，并且在不同条件下，因为只需要单次手术，从而节省了长时间的病假，其功能结果与传统技术相当。
