Artikel
Aesthetic reconstruction of thumb or finger partial pulp defect with free lateral great toe flap
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Autoren
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Zhangjun Pan
- Yixing People Hospital, Jiangsu University Affiliated Yixing Hospital, Wuxi Yixing, China
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: We retrospective reviewed the outcomes of reconstruction of thumb or finger partial pulp defect with free lateral great toe flap, and evaluated the outcomes of esthetic and sensory free toe flap reconstructed the digital pulp defects.
Methods: We performed 31 free toe pulp transfers for thumb or finger partial pulp reconstruction in 30 patients from May 2012 to October 2016: 10 men with 11 digits and 20 women with 20 digits. Their mean age was 36 years (21 - 54 years). The defects involved 15 thumbs, 8 index fingers, 4 long fingers and 4 ring fingers. The sizes of the free pulp flaps ranged from 21mm×12mm to 40mm×25mm. The artery and vein were anastomosed in an end-to-end pattern to the recipient vessels. The donor site of great toe was closed primarily or with a full-thickness skin graft from the groin. We used the Semmes-Weinstein monofilament test and the static two-point discrimination test to measure sensory recovery in the transferred pulps and donor sites of toes. We evaluated the esthetic appearance of the reconstructed digits using the Michigan Hand Outcomes Questionnaire. We also measured digital range of motion in the fingers without concurrent bone or tendon injuries.
Results and Conclusions: A total of 30 patients were all reconstructed in a second stag and followed for more than 12 mouths (average, 18.5 months). All of flaps were survived completely. One patient suffered local infection. Semmes-Weinstein sensitivity score was 2.43 to 3.78 (mean, 3.17) at the flap and 3.78 to 5.86 (mean, 4.93) at the donor sites of toes. The mean static two-point discrimination score was 6.71 mm.The mean esthetic appearance score was 16 according to Michigan Hand Outcomes Questionnaire. We found that 23 digits had extension deficits ranging from 5° to 25° (average, 13°) which compared with the contralateral uninjured digits.
The free lateral neurovascular bundles great toe pulp flap is an efficient and reliable flap for the reconstruction of digital partial pulp defects.
