Repair of thumb defects with modified radial dorsal fasciocutaneous flap of thumb_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

QIN Hongjiu ,  XIA Jiang , HU Bin , WANG Haisheng , XU Lei , WANG Yinze

Department of Hand and Foot Surgery, Yijishan Hospital of Wannan Medical Collage, Wuhu Anhui, 241001, P.R.China;

Corresponding author：

XIA Jiang, Email: woshilkxiaoqiang@163.com

Keywords：

Thumb; fasciocutaneous flap; tissue defect; repair

DOI：

10.7507/1002-1892.201703053

Video：

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ObjectiveTo investigate the operative method of repairing soft tissue defect of the thumb with modified radial dorsal fasciocutaneous flap and its effectiveness.MethodsBetween June 2015 and December 2016, 15 patients with volar or dorsal defects of the thumb were treated with modified radial dorsal fasciocutaneous flaps which distal pedicles were cut off. Of 15 cases, 11 were male and 4 were female, aged 35-70 years (mean, 46 years). The causes of injury included crush injury in 12 cases and avulsion injury in 3 cases. Because all patients had volar or dorsal defects of the thumb which were accompanied by tendon or bone exposure, they had no condition or desire to replant. There were 12 cases of volar defect of thumb and 3 cases of dorsal defect. The area of defects ranged from 2.0 cm×1.2 cm to 3.0 cm×2.5 cm. The time between injury and operation was 16 hours to 2 days (mean, 30.4 hours). The radial dorsal fascio-cutaneous flaps of 2.3 cm×1.5 cm to 3.3 cm×2.8 cm in size were adopted to repair defects. The donor sites were directly sutured.ResultsAll flaps survived, and no severe swelling or tension blister occurred. The donor sites and wounds healed by first intention. All patients were followed up 3-12 months (mean, 6 months). The color and texture of the grafted flaps were similar to those of normal skin, with no bloated appearance. According to total active motion standard at last follow-up, the finger function was excellent in 8 cases and good in 7 cases.ConclusionModified radial dorsal fasciocutaneous flap of the thumb is a reliable flap with easy dissection and less trauma in repair of soft tissue defects of the thumbs, and satisfactory clinical outcome can be obtained.

Citation： QIN Hongjiu, XIA Jiang, HU Bin, WANG Haisheng, XU Lei, WANG Yinze. Repair of thumb defects with modified radial dorsal fasciocutaneous flap of thumb. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(7): 841-844. doi: 10.7507/1002-1892.201703053 Copy

1.	Lemmon JA, Janis JE, Rohrich RJ. Soft-tissue injuries of the fingertip: methods of evaluation and treatment. An algorithmic approach. Plast Reconstr Surg, 2008, 122(3): 105e-117e.
2.	Hrabowski M, Kloeters O, Germann G. Reverse homodigital dorsoradial flap for thumb soft tissue reconstruction: surgical technique. J Hand Surg (Am), 2010, 35(4): 659-662.
3.	毛莉颖, 黄东, 江奕恒, 等. 手部不同远端蒂皮瓣静脉回流障碍的原因分析. 中国临床解剖学杂志, 2013, 31(4): 484-486.
4.	张世民, 袁锋, 俞光荣, 等. 远端蒂拇指背尺侧皮瓣修复指端缺损及静脉回流. 中国临床解剖学杂志, 2005, 23(2): 206-208.
5.	潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.
6.	Bao QY, Xiao CW, Peng F, et al. Restoration of thumb sensibility with innervated reverse homodigital dorsoradial flap. J Reconstr Microsurg, 2014, 30(1): 15-20.
7.	Sun YC, Gong YP, Chen QZ. A reverse dorsoradial pedicled flap from the thumb for a soft tissue defect in the finger. J Hand Surg (Eur Vol), 2015, 40(9): 1000-1001.
8.	Lazzeri D, Huemer GM, Nicoli F, et al. Indications, outcomes, and complications of pedicled propeller perforator flaps for upper body defects: asystematic review. Arch Plast Surg, 2013, 40(1): 44-50.
9.	代杰志, 柴益民. 远端蒂隐神经营养血管皮瓣研究进展. 国际骨科学杂志, 2013, 34(1): 53-54.
10.	Checcucci G, Galeano M, Zucchini M, et al. Reverse flow first dorsal metacarpal artery flap for covering the defect of distal thumb. Microsurgery, 2014, 34(4): 283-286.
11.	Ramírez AR, Gonzalez SM. Arteries of the thumb:, description of anatomical variations and review of the literature. Plast Reconstr Surg, 2012, 129(3): 468e-476e.
12.	Moschella F, Cordova A. Reverse homodigital dorsal radial flap of the thumb. Plast Reconstr Surg, 2006, 117(3): 920-926.
13.	Sun YC, Chen QZ, Chen J, et al. Reverse Dorsoradial Flaps for Thumb Coverage Show Increased Sensory Recovery with Smaller Flap Sizes. J Reconstr Microsurg, 2015, 31(6): 426-433.
14.	梁成, 谢昀, 郑和平, 等. 穿支蒂足背外侧皮神经浅静脉营养血管皮瓣的解剖基础. 中国临床解剖学杂志, 2014, 32(4): 377-380.
15.	张发惠, 谢其扬, 郑和平, 等. 腓肠神经-小隐静脉营养血管远端蒂皮瓣动脉穿支的应用解剖. 中国修复重建外科杂志, 2005, 19(7): 501-504.
16.	张世民, 刘大雄, 张连生, 等. 远端蒂皮瓣的血液循环特征及临床意义. 中国临床解剖学杂志, 1998, 16(2): 103-106.
17.	Akita S, Mitsukawa N, Rikihisa N, et al. Reconstruction of the great toe using a pedicled medial plantar flap with anterograde venous drainage. Microsurgery, 2014, 34(5): 398-403.
18.	查选平, 周赤龙, 金钟鸣, 等. 经皮缝扎阻断小隐静脉回流降低远端蒂腓肠神经营养血管皮瓣静脉瘀血的临床研究. 中华损伤与修复杂志(电子版), 2009, 4(3): 16-19.

1. Lemmon JA, Janis JE, Rohrich RJ. Soft-tissue injuries of the fingertip: methods of evaluation and treatment. An algorithmic approach. Plast Reconstr Surg, 2008, 122(3): 105e-117e.
2. Hrabowski M, Kloeters O, Germann G. Reverse homodigital dorsoradial flap for thumb soft tissue reconstruction: surgical technique. J Hand Surg (Am), 2010, 35(4): 659-662.
3. 毛莉颖, 黄东, 江奕恒, 等. 手部不同远端蒂皮瓣静脉回流障碍的原因分析. 中国临床解剖学杂志, 2013, 31(4): 484-486.
4. 张世民, 袁锋, 俞光荣, 等. 远端蒂拇指背尺侧皮瓣修复指端缺损及静脉回流. 中国临床解剖学杂志, 2005, 23(2): 206-208.
5. 潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.
6. Bao QY, Xiao CW, Peng F, et al. Restoration of thumb sensibility with innervated reverse homodigital dorsoradial flap. J Reconstr Microsurg, 2014, 30(1): 15-20.
7. Sun YC, Gong YP, Chen QZ. A reverse dorsoradial pedicled flap from the thumb for a soft tissue defect in the finger. J Hand Surg (Eur Vol), 2015, 40(9): 1000-1001.
8. Lazzeri D, Huemer GM, Nicoli F, et al. Indications, outcomes, and complications of pedicled propeller perforator flaps for upper body defects: asystematic review. Arch Plast Surg, 2013, 40(1): 44-50.
9. 代杰志, 柴益民. 远端蒂隐神经营养血管皮瓣研究进展. 国际骨科学杂志, 2013, 34(1): 53-54.
10. Checcucci G, Galeano M, Zucchini M, et al. Reverse flow first dorsal metacarpal artery flap for covering the defect of distal thumb. Microsurgery, 2014, 34(4): 283-286.
11. Ramírez AR, Gonzalez SM. Arteries of the thumb:, description of anatomical variations and review of the literature. Plast Reconstr Surg, 2012, 129(3): 468e-476e.
12. Moschella F, Cordova A. Reverse homodigital dorsal radial flap of the thumb. Plast Reconstr Surg, 2006, 117(3): 920-926.
13. Sun YC, Chen QZ, Chen J, et al. Reverse Dorsoradial Flaps for Thumb Coverage Show Increased Sensory Recovery with Smaller Flap Sizes. J Reconstr Microsurg, 2015, 31(6): 426-433.
14. 梁成, 谢昀, 郑和平, 等. 穿支蒂足背外侧皮神经浅静脉营养血管皮瓣的解剖基础. 中国临床解剖学杂志, 2014, 32(4): 377-380.
15. 张发惠, 谢其扬, 郑和平, 等. 腓肠神经-小隐静脉营养血管远端蒂皮瓣动脉穿支的应用解剖. 中国修复重建外科杂志, 2005, 19(7): 501-504.
16. 张世民, 刘大雄, 张连生, 等. 远端蒂皮瓣的血液循环特征及临床意义. 中国临床解剖学杂志, 1998, 16(2): 103-106.
17. Akita S, Mitsukawa N, Rikihisa N, et al. Reconstruction of the great toe using a pedicled medial plantar flap with anterograde venous drainage. Microsurgery, 2014, 34(5): 398-403.
18. 查选平, 周赤龙, 金钟鸣, 等. 经皮缝扎阻断小隐静脉回流降低远端蒂腓肠神经营养血管皮瓣静脉瘀血的临床研究. 中华损伤与修复杂志(电子版), 2009, 4(3): 16-19.

Chinese Journal of Reparative and Reconstructive Surgery

Repair of thumb defects with modified radial dorsal fasciocutaneous flap of thumb

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