Objectives To assess the clinical outcomes of using a bipedicle advancement flap to cover the skin defects after digital mucous cyst (DMC) excision. Methods Data for 15 patients (18 fingers) with DMC, admitted to the Department of Orthopaedics and Surgery of the Affiliated Zhongshan Hospital of Dalian University from January 2016 to January 2018, were analyzed retrospectively. This study included 4 men and 11 women, with a mean age of 64 ± 7.8 years (range, 47–77 years). A total of 5 cases involved the thumb, 4 involved the index finger, 5 involved ithe middle finger, and 4 involved the ring finger. Among a total of 18 digital mucous cysts, 7 cases were in the left hand and 11 were in the right hand. Approximately 77.8% of cases had osteophytes. The cysts ranged in size from 0.5–1.0 cm to 0.7–1.2 cm. All patients underwent cyst and osteophyte excision and a bipedicle advancement flap to cover the resultant defect. The same surgical procedure was applied to all patients. Postoperative flap survival, healing, and infection were evaluated. The preoperative and postoperative ranges of motion (ROM) of the distal interphalangeal (DIP) and thumb interphalangeal joints (TIPJ) were recorded. Postoperative patient satisfaction was assessed by the visual analog scale (VAS, 0–10) during follow‐up visits. The Shapiro–Wilk test was used to determine whether the data for the difference between the preoperative and postoperative ROM of the DIP/TIPJ were normally distributed or not. The homogeneity of variance was expressed as mean ± standard deviation. A paired t‐test was used to compare the preoperative and postoperative ROM of the DIP/TIPJ. Results The patients were followed up for 20 ± 6.0 months (range, 12–36 months). All the flaps survived after surgery, and the incisions healed well. The sutures were removed 2 weeks postoperatively. No infections occurred and there was no cyst recurrence at follow up. After systemic physical therapy and functional exercises, the ROM of all the fingers was restored to the preoperative ROM by 1 month after surgery. The scores for patient satisfaction with surgery by means of the VAS were 8.5 ± 1.0 points, 2.8 ± 1.4 points, 2.0 ± 1.6 points, 1.5 ± 1.2 points, and 1.1 ± 1.3 points preoperatively, and 1, 3, 6, and 12 months postoperatively, respectively. The data for the difference between preoperative and postoperative VAS scores were normally distributed. There were significant differences between the preoperative and postoperative VAS scores. The preoperative DIP/TIPJ ROM was 71.7° ± 14.0°, and the postoperative ROM at 1, 3, 6, and 12 months were 69.3° ± 15.3°, 70.4° ± 12.7°, 71.5° ± 15.6°, and 71.8° ± 15.6°, respectively. The data for the difference between preoperative and postoperative ROM of the DIP/TIPJ were normally distributed. No difference was found between the preoperative and postoperative ROM. Conclusion The bipedicle advancement flap provides a simple and effective technique for covering skin defects following DMC excision.
Background : Many patients have skin defects after digital mucous cyst (DMC) excision, and this study aimed to assess the clinical outcomes of using a bipedicle advancement flap to cover such defects. Methods : From January 2016 to January 2018, DMCs on 18 fingers of 15 patients (4 males and 11 females, with a mean age of 64 years) were treated with cyst and osteophyte excision and a bipedicle advancement flap to cover the resultant defect in this retrospective study. Postoperative flap survival, healing and infection were evaluated. The pre- and postoperative ranges of motion (ROMs) of the distal interphalangeal (DIP) or thumb interphalangeal (IP) joints were recorded. Postoperative patients’ satisfaction was assessed by the visual analogue scale (VAS; 0~10). Results : The patients were followed up for 12-36 months (mean, 20 months). All the flaps survived, the incisions healed well without infection, and no cyst recurrence occurred. The postoperative ROM of the affected fingers was restored to the preoperative ROM by two months after surgery. No difference was found between the preoperative and postoperative ROMs. The score of patients’ satisfaction for surgery by means of VAS was 8.5±1.0. Conclusions : The bipedicle advancement flap is a simple and effective technique for covering skin defects following DMC excision.
Background Many patients have skin defects after digital mucous cyst (DMC) excision, and this study aimed to assess the clinical outcomes of using a bipedicle advancement flap to cover such defects.Methods From January 2016 to January 2018, DMCs on 18 fingers of 15 patients (4 males and 11 females, with a mean age of 64 years) were treated with cyst and osteophyte excision and a bipedicle advancement flap to cover the resultant defect in this retrospective study. Postoperative flap survival, healing and infection were evaluated. The pre- and postoperative ranges of motion (ROMs) of the distal interphalangeal (DIP) or thumb interphalangeal (IP) joints were recorded. The patients were followed up for 12-36 months (mean, 20 months).Results All the flaps survived, the incisions healed well without infection, and no cyst recurrence occurred. The postoperative ROM of the affected fingers was restored to the preoperative ROM by two months after surgery. No difference was found between the preoperative and postoperative ROMs.Conclusions The bipedicle advancement flap is a simple and effective technique for covering skin defects following DMC excision.
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