Clinical observation of superficial branch of radial artery wrist crease flap for repairing ring tissue defect of fingers_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHENG Ding ¹ ,  HU Junsheng ² , CUI Shuying ¹ , ZHANG Jichao ² , LI Dongfang ² , SHI Rongjian ² , XU Li ² , SHOU Kuishui ²

1. Department of Burns and Plastic Surgery, Pingdingshan Traditional Pingmei Shenma Medical Hospital, Pingdingshan Henan, 467000, P.R.China;
2. Department of Hand and Foot Microsurgery, Xuzhou Renci Hospital, Xuzhou Jiangsu, 221000, P.R.China;

Corresponding author：

HU Junsheng, Email: hjs120@139.com

Keywords：

Superficial branch of radial artery; wrist crease flap; ring finger tissue defect; repair

DOI：

10.7507/1002-1892.201703096

Video：

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Objective To explore the effectiveness and operation method of the superficial branch of radial artery wrist crease flap for repair of ring tissue defect of the fingers. Methods Between June 2013 and March 2016, the superficial branch of radial artery wrist crease flap was used to repair ring finger tissue defect in 20 cases (21 fingers). There were 14 males and 6 females with an average age of 39.3 years (range, 12-61 years). The causes included machine injury in 9 cases, traffic accident injury in 6 cases, heat inury in 2 cases, and avulsed injury in 3 cases. The index finger was involved in 6 cases, middle finger in 6 cases, ring finger in 3 cases, and little finger in 6 cases. Combined injuries included exposure of bone, tendon, vessel, and nerve. The mean time of injury to operation was 3 hours (range, 0.5-5.5 hours) in 17 patients undergoing emergency operation, and was 8.5 days (range, 7-10 days) in 3 patients undergoing selective operation. The superficial palmar branch of the radial artery from the flap was used for bridging proper digital artery. The donor site was directly sutured in 19 cases and was repaired by skin grafting in 1 case. Results One case had blood blister at distal flap, which was cured after dressing change; the other flaps survived, and primary healing was obtained. Healing of incision at the donor site healed by first intention. The patients were followed up 6-24 months (mean, 12 months). The appearance, texture, and color of the flaps were satisfactory. The two-point discrimination ranged from 6 to 13 mm (mean, 9 mm) at 6 months after operation. According to the Chinese Medical Association Society of hand surgery of thumb and finger reconstruction function evaluation standard, the results were excellent in 13 cases, good in 4 cases, and fair in 3 cases; the excellent and good rate was 85%. Conclusion The superficial branch of radial artery wrist crease flap is an ideal choice for the repair of ring tissue defect of the fingers.

Citation： CHENG Ding, HU Junsheng, CUI Shuying, ZHANG Jichao, LI Dongfang, SHI Rongjian, XU Li, SHOU Kuishui. Clinical observation of superficial branch of radial artery wrist crease flap for repairing ring tissue defect of fingers. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(7): 837-840. doi: 10.7507/1002-1892.201703096 Copy

1.	张世明, 王欣, 唐茂林, 等. 穿支皮瓣的争论与当前共识. 中华显微外科杂志, 2014, 37(1): 3-4.
2.	芮永军, 张雁, 杨红, 等. 术前不同定位方法在股前外侧穿支皮瓣应用的对比分析. 中华显微外科杂志, 2015, 38(1): 33-37.
3.	尚修超, 张乃臣, 刘宏君, 等. 游离桡动脉掌浅支皮瓣修复手指软组织缺损. 中华手外科杂志, 2015, 31(1): 77.
4.	郑大伟, 黎章灿, 曹广超, 等. 多种类型的桡动脉掌浅支腕横纹部游离皮瓣修复手指复合软组织缺损. 中华显微外科杂志, 2016, 39(1): 12-16.
5.	金日浩, 王夫平, 冷树立. 桡动脉浅支皮瓣修复指腹缺损的临床应用. 临床外科杂志, 2013, 21(9): 709-710.
6.	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.
7.	Muyldermans T, Hierner R. First dorsal metacarpal artery flap for thumb reconstruction: a retrospective clinical study. Strategies Trauma Limb Reconstr, 2009, 4(1): 27-33.
8.	沈永辉, 季卫平, 李浩. 带感觉腕横纹穿支皮瓣游离移植修复 16 例手指外伤缺损. 中华显微外科杂志, 2016, 39(2): 193-194.
9.	朱小弟, 李文庆, 毛仁群, 等. 多种指动脉皮(筋膜)瓣修复手指软组织缺损. 中华显微外科杂志, 2015, 38(1): 77-79.
10.	冯仕明, 王爱国, 高顺红, 等. 手指中末节脱套伤的显微外科治疗. 中华显微外科杂志, 2015, 38(4): 383-385.
11.	Song D, Deng X, Chen Y, et al. Thinned chimeric radial collateral artery perforator flap in complex distal thumb reconstruction. Archorthop Truama Surg, 2015, 135(11): 1623-1631.
12.	Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers. Plast Reconstr Surg, 2003, 111(4): 1412-1422.
13.	周晓, 许亚军, 芮永军, 等. 大鱼际部穿支皮瓣在拇指及虎口狭长瘢痕挛缩中的应用. 中华整形外科杂志, 2013, 29(3): 181-183.
14.	费剑荣, 杨科跃, 孙涛, 等. 游离大鱼际部穿支皮瓣修复指腹软组织缺损. 中华手外科杂志, 2013, 29(3): 157-158.
15.	Zheng DW, Li ZC, Sun F, et al. Use of a distal ulnar artery perforator-based bilobed free flap for repairing complex digital defects. J Hand Surg (Am), 2014, 39(11): 2235-2242.
16.	Yang JW, Kim JS, Lee DC, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. Reconstr Microsurg, 2010, 26(8): 529-538.
17.	Lee TP, Liao CY, Wu LC, et al. Free flap from the superficial palmar branch of the radial artery (SPBRA Flap) for finger reconstruction. Trauma, 2009, 66(4): 1173-1179.
18.	赵民, 田德虎, 邵新中, 等. 腕部掌侧桡动脉掌浅支横行微型皮瓣的解剖学研究. 中国修复重建外科杂志, 2013, 27(7): 864-868.

1. 张世明, 王欣, 唐茂林, 等. 穿支皮瓣的争论与当前共识. 中华显微外科杂志, 2014, 37(1): 3-4.
2. 芮永军, 张雁, 杨红, 等. 术前不同定位方法在股前外侧穿支皮瓣应用的对比分析. 中华显微外科杂志, 2015, 38(1): 33-37.
3. 尚修超, 张乃臣, 刘宏君, 等. 游离桡动脉掌浅支皮瓣修复手指软组织缺损. 中华手外科杂志, 2015, 31(1): 77.
4. 郑大伟, 黎章灿, 曹广超, 等. 多种类型的桡动脉掌浅支腕横纹部游离皮瓣修复手指复合软组织缺损. 中华显微外科杂志, 2016, 39(1): 12-16.
5. 金日浩, 王夫平, 冷树立. 桡动脉浅支皮瓣修复指腹缺损的临床应用. 临床外科杂志, 2013, 21(9): 709-710.
6. 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.
7. Muyldermans T, Hierner R. First dorsal metacarpal artery flap for thumb reconstruction: a retrospective clinical study. Strategies Trauma Limb Reconstr, 2009, 4(1): 27-33.
8. 沈永辉, 季卫平, 李浩. 带感觉腕横纹穿支皮瓣游离移植修复 16 例手指外伤缺损. 中华显微外科杂志, 2016, 39(2): 193-194.
9. 朱小弟, 李文庆, 毛仁群, 等. 多种指动脉皮(筋膜)瓣修复手指软组织缺损. 中华显微外科杂志, 2015, 38(1): 77-79.
10. 冯仕明, 王爱国, 高顺红, 等. 手指中末节脱套伤的显微外科治疗. 中华显微外科杂志, 2015, 38(4): 383-385.
11. Song D, Deng X, Chen Y, et al. Thinned chimeric radial collateral artery perforator flap in complex distal thumb reconstruction. Archorthop Truama Surg, 2015, 135(11): 1623-1631.
12. Sakai S. Free flap from the flexor aspect of the wrist for resurfacing defects of the hand and fingers. Plast Reconstr Surg, 2003, 111(4): 1412-1422.
13. 周晓, 许亚军, 芮永军, 等. 大鱼际部穿支皮瓣在拇指及虎口狭长瘢痕挛缩中的应用. 中华整形外科杂志, 2013, 29(3): 181-183.
14. 费剑荣, 杨科跃, 孙涛, 等. 游离大鱼际部穿支皮瓣修复指腹软组织缺损. 中华手外科杂志, 2013, 29(3): 157-158.
15. Zheng DW, Li ZC, Sun F, et al. Use of a distal ulnar artery perforator-based bilobed free flap for repairing complex digital defects. J Hand Surg (Am), 2014, 39(11): 2235-2242.
16. Yang JW, Kim JS, Lee DC, et al. The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation. Reconstr Microsurg, 2010, 26(8): 529-538.
17. Lee TP, Liao CY, Wu LC, et al. Free flap from the superficial palmar branch of the radial artery (SPBRA Flap) for finger reconstruction. Trauma, 2009, 66(4): 1173-1179.
18. 赵民, 田德虎, 邵新中, 等. 腕部掌侧桡动脉掌浅支横行微型皮瓣的解剖学研究. 中国修复重建外科杂志, 2013, 27(7): 864-868.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical observation of superficial branch of radial artery wrist crease flap for repairing ring tissue defect of fingers

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