Treatment of fingertip avulsion injuries using two periposition pedicled flaps

Zhang, Jian‐feng; Wang, Lei; Hao, Ruizheng; Huo, Yongxin; Yang, Hun‐Mu; Hu, Yongcheng

doi:10.1016/j.bjps.2018.12.051

Cited by 8 publications

(5 citation statements)

References 29 publications

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“…If the wound is not treated in time or the treatment method is incorrect, it may even cause amputation, leading to lifelong disability of the patient. e repeated infection of the wound not only causes delayed healing of the defect wound, but in severe cases, bacteria invade the blood circulation and multiply, causing sepsis and threatening the life of the patient [17,18]. erefore, the treatment of skin and soft tissue defect of hand and foot cannot be ignored.…”

Section: Discussionmentioning

confidence: 99%

Clinical Application of Artificial Dermis and Autologous Skin in Repairing Skin and Soft Tissue Defects of Hands and Feet with Bone Exposure Injuries

Song

Lei

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Patients with skin and soft tissue defects are very common. Mild trauma often causes mild skin damage, while severe injuries are often accompanied by bone and tendon exposure, which brings great pain to patients. For the defect of skin and soft tissue, the traditional treatment methods are mostly medium or full-thickness skin or skin flap transplantation. These methods are effective in wound repair, but there are still many problems. In recent years, with the improvement of tissue engineering technology, the use of artificial skin to repair various skin wounds is gradually becoming clinical, and the key technology of skin tissue engineering lies in the development of dermal substitutes. The appearance of artificial dermis not only solves the shortage of autologous skin source but also makes the operation simple and easy. The purpose of this study was to investigate the clinical effect of artificial dermis combined with autologous skin grafts in repairing hand and foot skin and soft tissue defects with bone exposure. The results show that the use of artificial dermis combined with autogenous blade thick skin to treat patients with hand and foot soft tissue injury with bone exposure has a good clinical effect, and the skin is alive and has fewer complications, which is worthy of promotion.

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Section: Discussionmentioning

confidence: 99%

Clinical Application of Artificial Dermis and Autologous Skin in Repairing Skin and Soft Tissue Defects of Hands and Feet with Bone Exposure Injuries

Song

Lei

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Studies have reported that an average of 10 mm in the static 2PD test when a "senseless" reverse digital ar-tery island flap has been performed. 23,24 Conversely, other studies have demonstrated a normal static 2PD test (1-5 mm) following neurovascular island flaps. 25,26 The findings of these studies indicate a reduced ability of flaps to restore sensation in the absence of nerve connections.…”

Section: Discussionmentioning

confidence: 95%

“…The sensory reconstruction of fingers is an important part in the hand surgery. Studies have reported that an average of 10 mm in the static 2PD test when a “senseless” reverse digital artery island flap has been performed 23,24 . Conversely, other studies have demonstrated a normal static 2PD test (1–5 mm) following neurovascular island flaps 25,26 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Application of a Modified Local Transposition Flap (Parallelogram Flap) Surgery in Repairing Fingertip Defects

et al. 2022

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ObjectiveParallelogram flap was performed for transverse finger amputation with the loss of distal pulp, nails, and bone. This study aimed to compare the clinical effects of parallelogram flap, antegrade homodigital island flaps, and reverse digital artery island flaps in fingertip reconstruction.Patients and MethodsFrom January 2017 to January 2021, clinical patient data with parallelogram flaps (78 cases), antegrade homodigital island flaps (78 cases), and reverse digital artery island flaps (78 cases) to repair fingertip defects were collected and analyzed. Two hundred thirty-four cases (234 fingers) were included in our study. All operations were performed by one surgical team. The operation time, 2-point discrimination, total active movement, and the Michigan Hand Questionnaire (MHQ) of the injured fingers were recorded to evaluate the therapeutic effect.ResultsParallelogram flaps (group A), antegrade homodigital island flaps (group B), and reverse digital artery island flaps (group C) had survived postoperatively. The operative duration of group A is the shortest (A < B < C, P < 0.05). At the last 6-month follow-up, there was no difference with the 2-point discrimination of the palmar part of the flaps in group A and group B but better than group C (P < 0.05). There was no difference with the total active movement of injured figures in 3 groups (P > 0.05). The MHQ summary scores in group A were much higher than those in group B and group C (P < 0.05). Evaluation of the MHQ subscale performance showed that the overall hand function, activities of daily living, work performance, and pain score had no differences (P > 0.05), but aesthetics and satisfaction score was the highest in group A (A > B > C, P < 0.05).ConclusionsThe reconstruction of transverse finger amputation using parallelogram flaps can achieve a shorter operation time, a more satisfying appearance. Parallelogram flaps and antegrade homodigital island flaps can both achieve a better sensory recovery. Parallelogram flaps is a better choice for reconstruction of transverse finger amputation with the loss of distal pulp, nails, and bone.

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“…The practice of sensory or non-sensory reconstruction of fingers remains controversial and debatable among hand surgeons. Studies have reported an average of 10 mm in the static two-point discrimination test when a “senseless” reverse digital artery island flap has been performed [ 23 , 24 ]. Conversely, other studies have demonstrated a normal static two-point discrimination test (1–5 mm) following neurovascular island flaps [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Parallelogram flap versus homodigital island flap in the treatment of fingertip defects with bone exposure: a prospective controlled study

Zhang

Wang

et al. 2022

J Orthop Surg Res

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Purpose A modified local transposition flap (we call it “parallelogram flap”) surgery was performed for fingertip injuries. This study aimed to compare the clinical effects of parallelogram flap and homodigital island flaps in fingertip reconstruction. Methods The study collected patients who underwent parallelogram transposition flaps and homodigital island flaps to repair fingertip defects from 2019 to 2021. 150 cases (150 fingers) were included in our study. All operations were performed by one surgical team. Record the operation time, two-point discrimination (2PD), Total Active Movement (TAM) and the MHQ (Michigan Hand Questionnaire) of the injured fingers to evaluate the therapeutic effect. Results All parallelogram (Group A) and homodigital island flap (Group B) had survived postoperatively. The operative duration of Group A (31.2 ± 3.3 min) is shorter than Group B (97.8 ± 6.1 min) (P < 0.05). At the 6-month follow-up, there was no difference with the two-point discrimination (2PD) of the palmar part of the flaps and the Total Active Movement (TAM) of injured figures in Group A and Group B. The MHQ summary scores in Group A (94.29 ± 3.14) were much higher than in Group B (91.73 ± 3.41) (P < 0.05). Evaluation of the MHQ subscale performance showed that the overall hand function, activities of daily living, work performance and pain score had no differences(P > 0.05), but aesthetics (92.15 ± 7.16) and satisfaction (92.45 ± 5.61) score in Group A was higher than aesthetics (86.56 ± 5.60) and satisfaction (86.72 ± 8.21) score in Group B (P < 0.05 for both). Conclusions The reconstruction using parallelogram flaps is a easier and more versatile treatment with better functions, less morbidity and better aesthetics. This method is a better choice for reconstruction of fingertip injury.

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Treatment of fingertip avulsion injuries using two periposition pedicled flaps

Cited by 8 publications

References 29 publications

Clinical Application of Artificial Dermis and Autologous Skin in Repairing Skin and Soft Tissue Defects of Hands and Feet with Bone Exposure Injuries

Clinical Application of Artificial Dermis and Autologous Skin in Repairing Skin and Soft Tissue Defects of Hands and Feet with Bone Exposure Injuries

Clinical Application of a Modified Local Transposition Flap (Parallelogram Flap) Surgery in Repairing Fingertip Defects

Parallelogram flap versus homodigital island flap in the treatment of fingertip defects with bone exposure: a prospective controlled study

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