Clinical application of neurovascular staghorn flap for repairing of defects in fingertips_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YI Lankai , XU Zhiyong , SUN Jianmin ,  CAO Zhenhao

Department of Hand and Foot Orthopedics, Weifang People’s Hospital, Weifang Shandong, 261041, P. R. China;

Corresponding author：

CAO Zhenhao, Email: 619202811@qq.com

Keywords：

Fingertip defect; staghorn flap; V-Y flap; finger neurovascular bundle

DOI：

10.7507/1002-1892.202303060

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the effectiveness of neurovascular staghorn flap for repairing defects in fingertips. Methods Between August 2019 and October 2021, a total of 15 fingertips defects were repaired with neurovascular staghorn flap. There were 8 males and 7 females with an average age of 44 years (range, 28-65 years). The causes of injury included 8 cases of machine crush injury, 4 cases of heavy object crush injury, and 3 cases of cutting injury. There were 1 case of thumb, 5 cases of index finger, 6 cases of middle finger, 2 cases of ring finger, and 1 case of little finger. There were 12 cases in emergency, and 3 cases with finger tip necrosis after trauma suture. Bone and tendon exposed in all cases. The range of fingertip defect was 1.2 cm×0.8 cm to 1.8 cm×1.5 cm, and the range of skin flap was 2.0 cm×1.5 cm to 2.5 cm×2.0 cm. The donor site was sutured directly. Results All flaps survived without infection or necrosis, and the incisions healed by first intention. All patients were followed up 6-12 months, with an average of 10 months. At last follow-up, the appearance of the flap was satisfactory, the wear resistance was good, the color was similar to the skin of the finger pulp, and there was no swelling; the two-point discrimination of the flap was 3-5 mm. One patient had linear scar contracture on the palmar side with slight limitation of flexion and extension, which had little effect on the function; the other patients had no obvious scar contracture, good flexion and extension of the fingers, and no dysfunction. The finger function was evaluated according to the total range of motion (TAM) system of the Hand Surgery Society of Chinese Medical Association, and excellent results were obtained in 13 cases and good results in 2 cases. Conclusion The neurovascular staghorn flap is a simple and reliable method to repair fingertip defect. The flap has a good fit with the wound without wasting skin. The appearance and function of the finger are satisfactory after operation.

Citation： YI Lankai, XU Zhiyong, SUN Jianmin, CAO Zhenhao. Clinical application of neurovascular staghorn flap for repairing of defects in fingertips. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(6): 717-720. doi: 10.7507/1002-1892.202303060 Copy

1.	仇申强, 王增涛, 孙法威, 等. 携带单侧指动脉及神经的长V-Y推进皮瓣修复指端缺损. 中国修复重建外科杂志, 2016, 30(8): 1049-1050.
2.	李忠哲, 苏彦农, 胡琪, 等. 带指神经血管蒂的V-Y岛状推进皮瓣治疗指端皮肤缺损. 中华手外科杂志, 2003, 19(4): 203-205.
3.	周飞亚, 高伟阳, 吴剑彬, 等. 血管神经蒂V-Y皮瓣修复手指末节Ⅱ区皮肤缺损. 中华手外科杂志, 2017, 33(5): 364-366.
4.	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.
5.	王晓松, 巨积辉, 吕文涛, 等. 带趾底固有神经和带趾背神经的第二趾胫侧皮瓣修复指端缺损的疗效对比. 中华手外科杂志, 2020, 36(3): 168-172.
6.	刘刚义, 许向东, 朱修文, 等. 邻指皮瓣联合指骨与甲床重建难以再植的末节断指. 中华手外科杂志, 2020, 36(6): 444-445.
7.	施海峰, 芮永军, 沙一帆, 等. 重建手指指腹常用的两种皮瓣感觉恢复比较. 中华手外科杂志, 2021, 37(6): 410-413.
8.	吴波, 廖苏平, 危蕾, 等. 手指侧方皮支血管链皮瓣和指动脉岛状皮瓣修复指端缺损的疗效比较. 中华手外科杂志, 2016, 32(6): 464-465.
9.	孙艺, 赵晓航, 胡振业, 等. 中节指动脉终末背侧穿支螺旋桨皮瓣修复指端皮肤缺损. 中华手外科杂志, 2016, 32(5): 343-344.
10.	胡浩良, 李学渊, 王胜伟, 等. 微型穿支螺旋桨皮瓣修复手指皮肤软组织缺损. 中华手外科杂志, 2016, 32(3): 190-193.
11.	Chakraborty SS, Kala PC, Sahu RK, et al. Fingertip amputation reconstruction with VY advancement flap: Literature review and comparative analysis of atasoy and kutler flaps. World J Plast Surg, 2021, 10(3): 8-17.
12.	Elliot D, Moiemen NS, Jigiinni VS. The neurowascular tranquilli-Leali flap. J Hand Surg (Br), 1995, 20(6): 815-823.
13.	侯桥, 富红梅, 任国华, 等. 单皮下蒂V-Y推进皮瓣联合蒂部植皮修复指端软组织缺损. 中华显微外科杂志, 2022, 45(2): 171-174.
14.	周飞亚, 吴剑彬, 张弦, 等. 改良单侧血管神经蒂V-Y皮瓣修复末节指腹皮肤缺损. 中华手外科杂志, 2018, 34(6): 410-412.

1. 仇申强, 王增涛, 孙法威, 等. 携带单侧指动脉及神经的长V-Y推进皮瓣修复指端缺损. 中国修复重建外科杂志, 2016, 30(8): 1049-1050.
2. 李忠哲, 苏彦农, 胡琪, 等. 带指神经血管蒂的V-Y岛状推进皮瓣治疗指端皮肤缺损. 中华手外科杂志, 2003, 19(4): 203-205.
3. 周飞亚, 高伟阳, 吴剑彬, 等. 血管神经蒂V-Y皮瓣修复手指末节Ⅱ区皮肤缺损. 中华手外科杂志, 2017, 33(5): 364-366.
4. 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.
5. 王晓松, 巨积辉, 吕文涛, 等. 带趾底固有神经和带趾背神经的第二趾胫侧皮瓣修复指端缺损的疗效对比. 中华手外科杂志, 2020, 36(3): 168-172.
6. 刘刚义, 许向东, 朱修文, 等. 邻指皮瓣联合指骨与甲床重建难以再植的末节断指. 中华手外科杂志, 2020, 36(6): 444-445.
7. 施海峰, 芮永军, 沙一帆, 等. 重建手指指腹常用的两种皮瓣感觉恢复比较. 中华手外科杂志, 2021, 37(6): 410-413.
8. 吴波, 廖苏平, 危蕾, 等. 手指侧方皮支血管链皮瓣和指动脉岛状皮瓣修复指端缺损的疗效比较. 中华手外科杂志, 2016, 32(6): 464-465.
9. 孙艺, 赵晓航, 胡振业, 等. 中节指动脉终末背侧穿支螺旋桨皮瓣修复指端皮肤缺损. 中华手外科杂志, 2016, 32(5): 343-344.
10. 胡浩良, 李学渊, 王胜伟, 等. 微型穿支螺旋桨皮瓣修复手指皮肤软组织缺损. 中华手外科杂志, 2016, 32(3): 190-193.
11. Chakraborty SS, Kala PC, Sahu RK, et al. Fingertip amputation reconstruction with VY advancement flap: Literature review and comparative analysis of atasoy and kutler flaps. World J Plast Surg, 2021, 10(3): 8-17.
12. Elliot D, Moiemen NS, Jigiinni VS. The neurowascular tranquilli-Leali flap. J Hand Surg (Br), 1995, 20(6): 815-823.
13. 侯桥, 富红梅, 任国华, 等. 单皮下蒂V-Y推进皮瓣联合蒂部植皮修复指端软组织缺损. 中华显微外科杂志, 2022, 45(2): 171-174.
14. 周飞亚, 吴剑彬, 张弦, 等. 改良单侧血管神经蒂V-Y皮瓣修复末节指腹皮肤缺损. 中华手外科杂志, 2018, 34(6): 410-412.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical application of neurovascular staghorn flap for repairing of defects in fingertips

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content