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Abstract：
BACKGROUND: In phalloplasty, there is a lack of standardized follow-up examinations of motor function and strength after harvesting oversized radial forearm free flaps (RFFF).
METHODS: We evaluated the donor site of 20 transmen after phalloplasty, using a multimodal, standardized approach, assessing the following parameters: opposition of the thumb, composite range of motion of the finger joints, grip strength, mobility of the wrist, lesion of the superficial branch of the radial nerve, the dorsal branch of the ulnar nerve, the sensation of pain, and cold intolerance. The contralateral, nonoperated forearm was used as a control.
RESULTS: No impairment of the mobility of the thumb (Kapandji score median 10, range 5-10) or fingers (all fingers at both sides pulp-to-palm 0 cm, nail-to-table 0 cm) were detected. Grip strength (median 36,3kg, p=0.629) and wrist extension (62.5°vs.70°, p=0.357), flexion (70°vs.70°, p=0.535), pronation (90°vs.90°), supination (90°vs.90°), radial (30°vs.30°, p=0.195), and ulnar deviation (40°vs.50°, p=0.125) did not statistically differ between donor and control hand. Injury of the dorsal branch of the ulnar nerve was uncommon (0% hypoesthesia, 10% positive Tinel\'s sign). We did not observe any persistent pain of the donor forearm (NRS median 0, range 0-9). We did observe irritation of the superficial branch of the radial nerve (hypoesthesia 40%, neuroma 45%).
CONCLUSIONS: The harvest of an oversized RFFF for phalloplasty does not cause any significant difference in motor function or strength between the donor and nonoperated hand. A potential risk of injuring the radial nerve branch is to be avoided. An aesthetic impairment could be addressed in future studies.
METHODS: We evaluated the donor site of 20 transmen after phalloplasty, using a multimodal, standardized approach, assessing the following parameters: opposition of the thumb, composite range of motion of the finger joints, grip strength, mobility of the wrist, lesion of the superficial branch of the radial nerve, the dorsal branch of the ulnar nerve, the sensation of pain, and cold intolerance. The contralateral, nonoperated forearm was used as a control.
RESULTS: No impairment of the mobility of the thumb (Kapandji score median 10, range 5-10) or fingers (all fingers at both sides pulp-to-palm 0 cm, nail-to-table 0 cm) were detected. Grip strength (median 36,3kg, p=0.629) and wrist extension (62.5°vs.70°, p=0.357), flexion (70°vs.70°, p=0.535), pronation (90°vs.90°), supination (90°vs.90°), radial (30°vs.30°, p=0.195), and ulnar deviation (40°vs.50°, p=0.125) did not statistically differ between donor and control hand. Injury of the dorsal branch of the ulnar nerve was uncommon (0% hypoesthesia, 10% positive Tinel\'s sign). We did not observe any persistent pain of the donor forearm (NRS median 0, range 0-9). We did observe irritation of the superficial branch of the radial nerve (hypoesthesia 40%, neuroma 45%).
CONCLUSIONS: The harvest of an oversized RFFF for phalloplasty does not cause any significant difference in motor function or strength between the donor and nonoperated hand. A potential risk of injuring the radial nerve branch is to be avoided. An aesthetic impairment could be addressed in future studies.
摘要：
背景：在阴茎成形术中，在收获超大尺寸的radial前臂游离皮瓣（RFFF）后，缺乏对运动功能和强度的标准化随访检查。
方法：我们评估了20个跨关节成形术后的供体部位，使用多模态，标准化方法，评估以下参数：拇指的反对，手指关节的复合运动范围，握力,手腕的移动性，the神经浅支病变，尺神经的背支,疼痛的感觉，冷不容忍。对侧，未手术的前臂用作对照。
结果：拇指（Kapandji评分中位数为10，范围为5-10）或手指（所有手指两侧的牙髓至手掌0厘米，指甲到桌子0厘米）被检测到。握力(中位数36,3kg,p=0.629)和手腕伸展(62.5°vs.70°,p=0.357),屈曲(70°vs.70°,p=0.535),内旋（90°vs.90°），旋光（90°vs.90°），径向(30°vs.30°,p=0.195)，和尺骨偏差(40°vs.50°，p=0.125）在供体手和对照手之间没有统计学差异。尺神经背支损伤并不常见（0%感觉减退，10%正Tinel\'s符号)。我们没有观察到供体前臂的任何持续性疼痛（NRS中位数0，范围0-9）。我们确实观察到radial神经浅支的刺激（感觉不足40％，神经瘤45%)。
结论：在供体和非手术手之间，采集超大尺寸的RFFF进行阴茎成形术不会导致运动功能或力量的任何显著差异。应避免损伤radial神经分支的潜在风险。美学障碍可以在未来的研究中解决。
方法：我们评估了20个跨关节成形术后的供体部位，使用多模态，标准化方法，评估以下参数：拇指的反对，手指关节的复合运动范围，握力,手腕的移动性，the神经浅支病变，尺神经的背支,疼痛的感觉，冷不容忍。对侧，未手术的前臂用作对照。
结果：拇指（Kapandji评分中位数为10，范围为5-10）或手指（所有手指两侧的牙髓至手掌0厘米，指甲到桌子0厘米）被检测到。握力(中位数36,3kg,p=0.629)和手腕伸展(62.5°vs.70°,p=0.357),屈曲(70°vs.70°,p=0.535),内旋（90°vs.90°），旋光（90°vs.90°），径向(30°vs.30°,p=0.195)，和尺骨偏差(40°vs.50°，p=0.125）在供体手和对照手之间没有统计学差异。尺神经背支损伤并不常见（0%感觉减退，10%正Tinel\'s符号)。我们没有观察到供体前臂的任何持续性疼痛（NRS中位数0，范围0-9）。我们确实观察到radial神经浅支的刺激（感觉不足40％，神经瘤45%)。
结论：在供体和非手术手之间，采集超大尺寸的RFFF进行阴茎成形术不会导致运动功能或力量的任何显著差异。应避免损伤radial神经分支的潜在风险。美学障碍可以在未来的研究中解决。
