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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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

1.	程国良. 不同形式的足趾移植拇手指再造与修复. 中华显微外科杂志, 2002, 25(1): 8-9.
2.	孙广峰, 魏在荣, 王利达, 等. 趾腓侧皮瓣游离移植修复手指掌侧皮肤缺损. 中国修复重建外科杂志, 2011, 25(4): 510-512.
3.	马立峰, 刘良燚, 李木卫, 等. 游离第二趾胫侧皮瓣修复手指中末节皮肤软组织缺损. 中华显微外科杂志, 2013, 36(6): 603-605.
4.	梁文仙, 匡星, 郑悦, 等. 手显微外科智能温控清创装置及其可调托架一体化的研制与应用. 实用手外科杂志, 2014, 28(2): 235-237.
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.	谢松林, 唐举玉, 陶克奇, 等. 指固有动脉背侧支为蒂的逆行掌指背筋膜皮瓣的应用解剖. 中国临床解剖学杂志, 2010, 28(1): 97-100.
7.	吴迪, 周围, 梁敏, 等. 近节指动脉背侧皮支皮瓣的临床应用. 中华显微外科杂志, 2011, 34(6): 492-493.
8.	钟世镇, 丁自海, 杜心如, 等. 临床解剖学丛书—脊柱与四肢分册. 2版. 北京: 人民卫生出版社, 2014: 109-110.
9.	周吉林, 姜华东, 张晓明, 等. 拇指指背动脉的应用解剖. 中国临床解剖学杂志, 2001, 19(4): 333-334.
10.	熊秉刚, 欧翰杰, 陈健, 等. 拇趾腓侧微型组织瓣的解剖及临床应用. 中国美容整形外科杂志, 2013, 24(2): 95-97.
11.	牟勇, 黄东, 吴伟炽, 等. 以趾背动脉为血供的趾背皮瓣应用解剖. 中国临床解剖学杂志, 2010, 28(6): 618-619.
12.	胡德锋, 赵晓航, 马建安, 等. 趾趾背动脉皮瓣的应用解剖. 中国临床解剖学杂志, 2014, 32(1): 5-7.
13.	陈乐锋, 张振伟, 游楚红, 等. 中指近节桡侧指动脉邻指逆行岛状皮瓣修复拇指指端缺损. 中华手外科杂志, 2014, 30(1): 44-46.
14.	章剑, 谢振军, 赵国红, 等. 掌背筋膜蒂岛状皮瓣修复示中指皮肤缺损. 中华手外科杂志, 2015, 31(6): 477.
15.	刘志功, 马广山, 冯会祥, 等. 拇指背侧逆行皮瓣的临床应用. 实用手外科杂志, 2012, 26(2): 117-119.

1. 程国良. 不同形式的足趾移植拇手指再造与修复. 中华显微外科杂志, 2002, 25(1): 8-9.
2. 孙广峰, 魏在荣, 王利达, 等. 趾腓侧皮瓣游离移植修复手指掌侧皮肤缺损. 中国修复重建外科杂志, 2011, 25(4): 510-512.
3. 马立峰, 刘良燚, 李木卫, 等. 游离第二趾胫侧皮瓣修复手指中末节皮肤软组织缺损. 中华显微外科杂志, 2013, 36(6): 603-605.
4. 梁文仙, 匡星, 郑悦, 等. 手显微外科智能温控清创装置及其可调托架一体化的研制与应用. 实用手外科杂志, 2014, 28(2): 235-237.
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. 谢松林, 唐举玉, 陶克奇, 等. 指固有动脉背侧支为蒂的逆行掌指背筋膜皮瓣的应用解剖. 中国临床解剖学杂志, 2010, 28(1): 97-100.
7. 吴迪, 周围, 梁敏, 等. 近节指动脉背侧皮支皮瓣的临床应用. 中华显微外科杂志, 2011, 34(6): 492-493.
8. 钟世镇, 丁自海, 杜心如, 等. 临床解剖学丛书—脊柱与四肢分册. 2版. 北京: 人民卫生出版社, 2014: 109-110.
9. 周吉林, 姜华东, 张晓明, 等. 拇指指背动脉的应用解剖. 中国临床解剖学杂志, 2001, 19(4): 333-334.
10. 熊秉刚, 欧翰杰, 陈健, 等. 拇趾腓侧微型组织瓣的解剖及临床应用. 中国美容整形外科杂志, 2013, 24(2): 95-97.
11. 牟勇, 黄东, 吴伟炽, 等. 以趾背动脉为血供的趾背皮瓣应用解剖. 中国临床解剖学杂志, 2010, 28(6): 618-619.
12. 胡德锋, 赵晓航, 马建安, 等. 趾趾背动脉皮瓣的应用解剖. 中国临床解剖学杂志, 2014, 32(1): 5-7.
13. 陈乐锋, 张振伟, 游楚红, 等. 中指近节桡侧指动脉邻指逆行岛状皮瓣修复拇指指端缺损. 中华手外科杂志, 2014, 30(1): 44-46.
14. 章剑, 谢振军, 赵国红, 等. 掌背筋膜蒂岛状皮瓣修复示中指皮肤缺损. 中华手外科杂志, 2015, 31(6): 477.
15. 刘志功, 马广山, 冯会祥, 等. 拇指背侧逆行皮瓣的临床应用. 实用手外科杂志, 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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