TOE FIBULAR-DORSAL ARTERY FLAP ANASTOMOSED TO DORSAL DIGITAL ARTERY IN REPAIRING DORSAL SOFT TISSUE DEFECT OF FINGERS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIMuwei , LIANGWenxian , LUOZhaohui , HUANGShaogeng ,  MALifeng , YANGYanjun , ZHANGZiqing

Department of Hand Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen Guangdong, 518116, P.R.China;

Corresponding?author：

MALifeng, Email: 1669421816@qq.com

Keywords：

Finger; Soft tissue defect; Toe fibular-dorsal artery flap; Wound repair

DOI：

10.7507/1002-1892.20160149

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To discuss the effectiveness of free toe fibular-dorsal artery flap anastomosed to dorsal digital artery in repairing dorsal soft tissue defect of fingers. Methods Between May 2010 and September 2015, 28 patients with dorsal soft tissue defect of fingers were treated, including 17 males and 11 females with an average age of 23.8 years (range, 15-55 years). The reasons of injuries were machine twist (15 cases), heavy pound (4 cases), the sharp cut (5 cases), and hot crush (4 cases). The time from injury to admission was 30 minutes to 12 hours (mean, 1.5 hours). The involved fingers included thumb (3 cases), index finger (8 cases), middle finger (6 cases), ring finger (6 cases), and little finger (5 cases). The area of soft?tissue?defects ranged from 2.0 cm×1.5 cm to 3.5 cm×2.5 cm, and the area of free toe fibular-dorsal artery flap ranged from 2.8 cm×1.7 cm to 3.8 cm×2.8 cm. The blood supply of the flaps were reconstructed by anastomosing the toe fibular-dorsal artery, vein, and nerve to the dorsal digital artery, vein, and nerve, respectively. The donor site was repaired by free skin graft. Results The operation time was 1.5-5.5 hours (mean, 2.5 hours); the blood loss during operation was 10-50 mL (mean, 30 mL). Vessel?crisis?occurred?in?1 case, and the flap survived after symptomatic treatment. The other flaps survived and the wounds healed with stage I; the skin grafts at donor site survived and the incisions healed with stage Ⅰ. Twenty-eight cases were followed up 6-24 months (mean, 8 months). The appearance of flaps was good, and two-point discrimination was 3.5-12.0 mm (mean, 5.3 mm) at 6 months after operation. The fingers function of grab and pinch recovered. According to the standard functional evaluation issued by Hand Surgery Association of Chinese Medical Association, the results were excellent in 20 cases and good in 8 cases, with an excellent and good rate of 100% at 6 months after operation. The donor sites of toe were smooth and had no depression. The patients had normal gait. Conclusion Free toe fibular-dorsal artery flap anastomosed to dorsal digital artery in repairing dorsal soft tissue defect of fingers can obtain satisfactory effectiveness in appearance and function of fingers, and has the advantages of modified repair and less injury at donor site.

Citation： LIMuwei, LIANGWenxian, LUOZhaohui, HUANGShaogeng, MALifeng, YANGYanjun, ZHANGZiqing. TOE FIBULAR-DORSAL ARTERY FLAP ANASTOMOSED TO DORSAL DIGITAL ARTERY IN REPAIRING DORSAL SOFT TISSUE DEFECT OF FINGERS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(6): 732-735. doi: 10.7507/1002-1892.20160149 Copy

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9.	周吉林, 姜華東, 張曉明, 等. 拇指指背動脈的應用解剖. 中國臨床解剖學雜志, 2001, 19(4): 333-334.
10.	熊秉剛, 歐翰杰, 陳健, 等. 拇趾腓側微型組織瓣的解剖及臨床應用. 中國美容整形外科雜志, 2013, 24(2): 95-97.
11.	牟勇, 黃東, 吳偉熾, 等. 以趾背動脈為血供的趾背皮瓣應用解剖. 中國臨床解剖學雜志, 2010, 28(6): 618-619.
12.	胡德鋒, 趙曉航, 馬建安, 等. 趾趾背動脈皮瓣的應用解剖. 中國臨床解剖學雜志, 2014, 32(1): 5-7.
13.	陳樂鋒, 張振偉, 游楚紅, 等. 中指近節橈側指動脈鄰指逆行島狀皮瓣修復拇指指端缺損. 中華手外科雜志, 2014, 30(1): 44-46.
14.	章劍, 謝振軍, 趙國紅, 等. 掌背筋膜蒂島狀皮瓣修復示中指皮膚缺損. 中華手外科雜志, 2015, 31(6): 477.
15.	劉志功, 馬廣山, 馮會祥, 等. 拇指背側逆行皮瓣的臨床應用. 實用手外科雜志, 2012, 26(2): 117-119.

1. ?程國良. 不同形式的足趾移植拇手指再造與修復. 中華顯微外科雜志, 2002, 25(1): 8-9.
2. 孫廣峰, 魏在榮, 王利達, 等. 趾腓側皮瓣游離移植修復手指掌側皮膚缺損. 中國修復重建外科雜志, 2011, 25(4): 510-512.
3. 馬立峰, 劉良燚, 李木衛, 等. 游離第二趾脛側皮瓣修復手指中末節皮膚軟組織缺損. 中華顯微外科雜志, 2013, 36(6): 603-605.
4. 梁文仙, 匡星, 鄭悅, 等. 手顯微外科智能溫控清創裝置及其可調托架一體化的研制與應用. 實用手外科雜志, 2014, 28(2): 235-237.
5. 潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3): 130-135.
6. 謝松林, 唐舉玉, 陶克奇, 等. 指固有動脈背側支為蒂的逆行掌指背筋膜皮瓣的應用解剖. 中國臨床解剖學雜志, 2010, 28(1): 97-100.
7. 吳迪, 周圍, 梁敏, 等. 近節指動脈背側皮支皮瓣的臨床應用. 中華顯微外科雜志, 2011, 34(6): 492-493.
8. 鐘世鎮, 丁自海, 杜心如, 等. 臨床解剖學叢書—脊柱與四肢分冊. 2版. 北京: 人民衛生出版社, 2014: 109-110.
9. 周吉林, 姜華東, 張曉明, 等. 拇指指背動脈的應用解剖. 中國臨床解剖學雜志, 2001, 19(4): 333-334.
10. 熊秉剛, 歐翰杰, 陳健, 等. 拇趾腓側微型組織瓣的解剖及臨床應用. 中國美容整形外科雜志, 2013, 24(2): 95-97.
11. 牟勇, 黃東, 吳偉熾, 等. 以趾背動脈為血供的趾背皮瓣應用解剖. 中國臨床解剖學雜志, 2010, 28(6): 618-619.
12. 胡德鋒, 趙曉航, 馬建安, 等. 趾趾背動脈皮瓣的應用解剖. 中國臨床解剖學雜志, 2014, 32(1): 5-7.
13. 陳樂鋒, 張振偉, 游楚紅, 等. 中指近節橈側指動脈鄰指逆行島狀皮瓣修復拇指指端缺損. 中華手外科雜志, 2014, 30(1): 44-46.
14. 章劍, 謝振軍, 趙國紅, 等. 掌背筋膜蒂島狀皮瓣修復示中指皮膚缺損. 中華手外科雜志, 2015, 31(6): 477.
15. 劉志功, 馬廣山, 馮會祥, 等. 拇指背側逆行皮瓣的臨床應用. 實用手外科雜志, 2012, 26(2): 117-119.

Chinese Journal of Reparative and Reconstructive Surgery

TOE FIBULAR-DORSAL ARTERY FLAP ANASTOMOSED TO DORSAL DIGITAL ARTERY IN REPAIRING DORSAL SOFT TISSUE DEFECT OF FINGERS

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