Application of ipsilateral digital proper artery dorsal branch flap to repair mid-phalanx degloving injury with distal segment finger defect_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YANG Huanyou , WANG Bin , HUANG Lei , LI Jingsong , WANG Wei

The First Department of Hand Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P.R.China;

Corresponding author：

YANG Huanyou, Email: yanghuanyou123@126.com

Keywords：

Finger injury; digital proper artery dorsal branch flap; degloving injury; wound repair

DOI：

10.7507/1002-1892.201804055

Video：

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Objective To investigate the effectiveness of ipsilateral digital proper artery dorsal branch flap to repair mid-phalanx degloving injury with distal segment finger defect. Methods Between February 2013 and July 2016, 11 cases (11 fingers) of mid-phalanx degloving injury with distal segment finger defect were treated. There were 9 males and 2 females with an average age of 33.6 years (range, 18-59 years). The injury caused by twisting in 8 cases and crushing in 3 cases. The injury located at index finger in 3 cases, middle finger in 6 cases, and ring finger in 2 cases. The skin avulsion was from proximal interphalangeal joint in 1 case, proximal 1/4 of mid-phalanx in 6 cases, and 1/2 of mid-phalanx in 4 cases. The area of wounds ranged from 4.0 cm×1.7 cm to 6.2 cm×2.6 cm. The interval between injury and operation was 2.5-6.0 hours (mean, 4.5 hours). All defects were repaired with the ipsilateral digital proper artery dorsal branch flaps. The size of flaps ranged from 4.4 cm×1.9 cm to 7.0 cm×2.9 cm. Nerve anastomose was carried between digital proper nerve dorsal branch in the flap and digital proper nerve stump in the wound. The donor sites were repaired by skin grafting. Results Tension blisters of the flap and partial necrosis occurred in 1 case, and healed after dressing change. The other flaps and skin grafting survived, and wounds healed by first intention. All patients were followed up 6-18 months (mean, 16 months). The texture and appearance of all the flaps were satisfactory. At 6 months after operation, two-point discrimination of flaps ranged from 7 to 10 mm (mean, 8.5 mm). At last follow-up, according to the functional assessment criteria of upper limbs by the Branch of Hand Surgery of Chinese Medicine Association, the results were excellent in 10 cases and good in 1 case, with the excellent and good rate of 100%. Conclusion The ipsilateral digital proper artery dorsal branch flap is a good method to repair mid-phalanx degloving injury with distal segment finger defect for the advantages of simple operation, less damage in donor site, high survival rate of the flap, and good feeling recovery of the finger.

Citation： YANG Huanyou, WANG Bin, HUANG Lei, LI Jingsong, WANG Wei. Application of ipsilateral digital proper artery dorsal branch flap to repair mid-phalanx degloving injury with distal segment finger defect. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(11): 1446-1449. doi: 10.7507/1002-1892.201804055 Copy

1.	芮永军, 施海峰, 邱扬, 等. 不同构制的ﾙ甲瓣修复手指脱套伤. 中华手外科杂志, 2007, 23(6): 349-351.
2.	潘达德, 顾玉东, 侍德. 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.
3.	卢耀军, 周福临. 带蒂腹部分层组织瓣结合自体皮移植一期修复手部皮肤脱套伤. 中华显微外科杂志, 2015, 38(2): 180-182.
4.	王怀玺, 左中男, 于绍斌, 等. 应用带掌背神经的掌背动脉皮瓣修复手指脱套伤. 中华显微外科杂志, 2013, 36(2): 198-200.
5.	强力, 薛明宇, 沈小芳, 等. 游离" M”形骨间背分叶肌皮瓣修复手指中末节脱套伤. 中华显微外科杂志, 2015, 38(2): 184-186.
6.	姚群, 芮永军, 寿奎水, 等. 游离尺动脉腕上穿支皮瓣修复套脱伤. 中华手外科杂志, 2014, 30(6): 411-413.
7.	沈鸿飞, 岳震双, 汤样华, 等. 第二趾胫侧皮瓣与ﾙ趾趾背皮瓣瓦合修复手指II度套脱伤. 中华手外科杂志, 2016, 32(6): 425-426.
8.	周建辉, 李秀文, 王夫平, 等. ﾙ甲皮瓣联合第二足趾胫侧皮瓣修复手指末节脱套伤. 中华显微外科杂志, 2015, 38(5): 516-517.
9.	Braga-Silva J, Kuyven CR, Fallopa F, et al. An anatomical study of the dorsal cutaneous branches of digital arteries. J Hand Surg (Br), 2002, 27(6): 577-579.
10.	Tellioglu AT, Sensoz O. The dorsal branch of the digital nerve: an anatomic study and clinical applications. Ann Plast Surg, 1998, 40(2): 145-148.
11.	张文龙, 赵刚, 马爱国, 等. 指掌侧固有动脉背侧支皮瓣的显微解剖与临床应用. 中华显微外科杂志, 2015, 38(2): 107-110.
12.	张剑锋, 胡永成, 王斌, 等. 同指" 双峰样”皮瓣修复手指远节套脱伤. 中华手外科杂志, 2017, 33(3): 184-186.
13.	徐达传. 手功能修复重建外科解剖学. 北京: 人民卫生出版社, 1996: 121-123.
14.	李海, 邓呈亮, 魏在荣, 等. 分叶股前外侧穿支皮瓣在血管蒂保护中的作用研究. 中国修复重建外科杂志, 2017, 31(10): 1245-1249.
15.	王培吉, 周忠良, 江波. 掌背动脉皮支蒂逆行筋膜皮瓣修复手指皮肤缺损. 中华手外科杂志, 2010, 26(1): 195-197.
16.	张文龙, 张文静, 杜晓松, 等. 指动脉背侧支皮瓣修复邻指皮肤缺损. 中华手外科杂志, 2014, 30(1): 66-68.
17.	杨林, 刘宏君, 张文忠, 等. 改良股前外侧游离穿支皮瓣桥式交叉移植修复小腿中下段软组织缺损. 中国修复重建外科杂志, 2017, 31(10): 1240-1244.

1. 芮永军, 施海峰, 邱扬, 等. 不同构制的ﾙ甲瓣修复手指脱套伤. 中华手外科杂志, 2007, 23(6): 349-351.
2. 潘达德, 顾玉东, 侍德. 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.
3. 卢耀军, 周福临. 带蒂腹部分层组织瓣结合自体皮移植一期修复手部皮肤脱套伤. 中华显微外科杂志, 2015, 38(2): 180-182.
4. 王怀玺, 左中男, 于绍斌, 等. 应用带掌背神经的掌背动脉皮瓣修复手指脱套伤. 中华显微外科杂志, 2013, 36(2): 198-200.
5. 强力, 薛明宇, 沈小芳, 等. 游离" M”形骨间背分叶肌皮瓣修复手指中末节脱套伤. 中华显微外科杂志, 2015, 38(2): 184-186.
6. 姚群, 芮永军, 寿奎水, 等. 游离尺动脉腕上穿支皮瓣修复套脱伤. 中华手外科杂志, 2014, 30(6): 411-413.
7. 沈鸿飞, 岳震双, 汤样华, 等. 第二趾胫侧皮瓣与ﾙ趾趾背皮瓣瓦合修复手指II度套脱伤. 中华手外科杂志, 2016, 32(6): 425-426.
8. 周建辉, 李秀文, 王夫平, 等. ﾙ甲皮瓣联合第二足趾胫侧皮瓣修复手指末节脱套伤. 中华显微外科杂志, 2015, 38(5): 516-517.
9. Braga-Silva J, Kuyven CR, Fallopa F, et al. An anatomical study of the dorsal cutaneous branches of digital arteries. J Hand Surg (Br), 2002, 27(6): 577-579.
10. Tellioglu AT, Sensoz O. The dorsal branch of the digital nerve: an anatomic study and clinical applications. Ann Plast Surg, 1998, 40(2): 145-148.
11. 张文龙, 赵刚, 马爱国, 等. 指掌侧固有动脉背侧支皮瓣的显微解剖与临床应用. 中华显微外科杂志, 2015, 38(2): 107-110.
12. 张剑锋, 胡永成, 王斌, 等. 同指" 双峰样”皮瓣修复手指远节套脱伤. 中华手外科杂志, 2017, 33(3): 184-186.
13. 徐达传. 手功能修复重建外科解剖学. 北京: 人民卫生出版社, 1996: 121-123.
14. 李海, 邓呈亮, 魏在荣, 等. 分叶股前外侧穿支皮瓣在血管蒂保护中的作用研究. 中国修复重建外科杂志, 2017, 31(10): 1245-1249.
15. 王培吉, 周忠良, 江波. 掌背动脉皮支蒂逆行筋膜皮瓣修复手指皮肤缺损. 中华手外科杂志, 2010, 26(1): 195-197.
16. 张文龙, 张文静, 杜晓松, 等. 指动脉背侧支皮瓣修复邻指皮肤缺损. 中华手外科杂志, 2014, 30(1): 66-68.
17. 杨林, 刘宏君, 张文忠, 等. 改良股前外侧游离穿支皮瓣桥式交叉移植修复小腿中下段软组织缺损. 中国修复重建外科杂志, 2017, 31(10): 1240-1244.

Chinese Journal of Reparative and Reconstructive Surgery

Application of ipsilateral digital proper artery dorsal branch flap to repair mid-phalanx degloving injury with distal segment finger defect

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