Repair of distal thumb degloving injury using combination of reverse dorsoradial flap of the thumb and middle finger pro
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(2020) 15:417
RESEARCH ARTICLE
Open Access
Repair of distal thumb degloving injury using combination of reverse dorsoradial flap of the thumb and middle finger proper digital arterial island flap Ruizheng Hao, Bin Wang*, Hui Wang, Huanyou Yang and Yongxin Huo
Abstract Background: To examine the efficacy of combination of the reverse dorsoradial flap of the thumb and middle finger proper digital arterial island flap for repair of distal thumb degloving injury. Methods: Twelve patients with mechanical distal thumb degloving injuries were treated between February 2017 and August 2019. A combination of the reverse dorsoradial flap of the thumb and the middle finger proper digital arterial island flap were used. Semmes–Weinstein (SW) monofilament and static two-point discrimination (S-2PD) tests, active range-of-motion (ROM) of the joints, cold intolerance, visual analog scale (VAS) score patient complications, and patient satisfaction were sequentially evaluated. Results: Two cases with postoperative flap blisters were treated at time of dressing changes up to successful scab formation. One case with postoperative arterial crisis of finger arterial dorsal branch vessel was successfully released in the pedicle. Ten cases healed by first intention and 2 cases by secondary intention. Twelve patients received follow-up examinations between 3 and 20 months (average 13 months) post-treatment, and all exhibited full, soft flaps with no fingertip pain. Conclusion: The combined use of the reverse dorsoradial flap of the thumb and the middle finger proper digital arterial island flap is a practical and effective approach to surgical repair of distal thumb degloving injuries. Keywords: Distal thumb degloving injury, Reverse dorsoradial flap of the thumb, Middle finger proper digital arterial island flap
Background Distal degloving injuries are common, but reconstruction of the thumb remains a challenge for surgeons [1]. Several procedures, including osteoplastic reconstruction with transferred pedicles of abdominal or forearm tissue and free vascularized transfer of the first or the second finger, have been tried in efforts to improve functional * Correspondence: wangbin0714@yeah.net Department of Hand Surgery, The Second Hospital of Tangshan, No.21 Jianshe North Road, Lubei District, Tangshan 063000, Hebei Province, People’s Republic of China
and aesthetic outcomes of thumb reconstruction. While treatment involving thumb shortening and suturing is straightforward, postoperatively the resulting abnormal thumb length has serious functional consequences [2]. A ventral skin tube can restore thumb length [3, 4], but the procedure requires a high degree of technical expertise and is associated with multiple drawbacks including bloated appearance, poor sensory outcomes, difficult thumb and nail free grafting, and high risk of surgical injuries [5–9].
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and r
