Han S K, Lee B I, Kim W K
Department of Plastic and Reconstructive Surgery at Korea University College of Medicine, Seoul.
Plast Reconstr Surg. 1998 Apr;101(4):1006-11; discussion 1012-3. doi: 10.1097/00006534-199804040-00018.
Fingertip injuries represent the most common type of injuries seen in the upper extremity. Their management is functionally and aesthetically important but at the same time very controversial. The aim of this study is to report usefulness and postoperative results of reverse digital artery island flaps for fingertip reconstruction. From July of 1984 to December of 1995, 120 fingers in 110 patients with defects of the distal phalanx were reconstructed by reverse digital artery island flaps at Korea University Guro Hospital. We reviewed the medical records of our cases and analyzed them in several aspects. In 21 cases, neurorrhaphy was performed to improve sensibility. In the majority of the cases, the defect was covered primarily, whereas in 27 cases it was covered secondarily after composite graft, replantation, and so on. All the flaps survived except for one. Long-term follow-up for more than 6 months was possible in 44 fingers in 41 patients. Light touch and temperature sensation could be detected in all the evaluated flaps. The mean values of the static two-point discrimination test in sensate and insensate flaps were 6.2 and 10.2 mm, respectively. The reverse digital artery island flap is a safe and reliable procedure with a high survival rate and therefore is an excellent choice for coverage of fingertip defects.
指尖损伤是上肢最常见的损伤类型。其处理在功能和美观方面都很重要，但同时也极具争议性。本研究的目的是报告逆行指动脉岛状皮瓣用于指尖重建的有效性及术后结果。1984年7月至1995年12月，韩国大学古罗医院采用逆行指动脉岛状皮瓣为110例远端指骨缺损患者的120根手指进行了重建。我们回顾了这些病例的病历，并从多个方面进行了分析。21例患者进行了神经缝合以提高感觉功能。大多数病例中，缺损得到了一期覆盖，而在27例中，在复合组织移植、再植等之后进行了二期覆盖。除1例皮瓣外，其余所有皮瓣均存活。41例患者的44根手指进行了超过6个月的长期随访。所有评估的皮瓣均能检测到轻触觉和温度觉。有感觉和无感觉皮瓣的静态两点辨别试验平均值分别为6.2毫米和10.2毫米。逆行指动脉岛状皮瓣是一种安全可靠的手术方法，成活率高，因此是覆盖指尖缺损的极佳选择。
