Martinot V
Service de Chirurgie Plastique et Reconstructive, CHR, Lille.
Ann Chir Plast Esthet. 1993 Aug;38(4):369-75.
The authors proposed their preferential indications to repair cutaneous loss of the thumb. The choice of the flap depend on localisation: to repair a frontal amputation, a triangular volar flap (Atazoy) performed, to repair a tangential distal amputation, a neurovascular island flap (O'Brien-Moberg) was used. To repair a tangential palmar amputation, a flap with advancement and rotation (Hueston) was performed--Free toe to finger tip neurovascular flap was necessary to restore sensation after complete avulsion of pulp. The island kite flap transfer from the dorsum of the index to the thumb (Foucher) was used to repair loss of dorsal and palmar side of the first phalanx. For tangential dorsal amputation, cross finger and free toe to thumb "custom-made" transfer were possible. The authors explained why they preferred these flaps.
作者们提出了修复拇指皮肤缺损的优先适应证。皮瓣的选择取决于缺损部位：修复近端截断伤时，采用三角形掌侧皮瓣（阿塔佐伊皮瓣）；修复远端切线状截断伤时，使用神经血管岛状皮瓣（奥布赖恩 - 莫伯格皮瓣）。修复掌侧切线状截断伤时，采用推进旋转皮瓣（休斯顿皮瓣）——在指腹完全撕脱后，需要游离趾 - 指尖神经血管皮瓣来恢复感觉。采用示指背侧岛状风筝皮瓣转移至拇指（富歇皮瓣）来修复近节指骨背侧和掌侧的缺损。对于背侧切线状截断伤，可行交叉手指皮瓣和游离趾 - 拇指“定制”转移皮瓣修复。作者解释了他们选择这些皮瓣的原因。
