Abstract：
One concern in the surgical treatment of radial longitudinal deficiency (RLD) is certainly the skin incision. Over the years many different types have been proposed and used. We propose a new skin incision technique: a double Y sliding flap with the main body along the dorsal wrist crease, followed by raising a proximal and a distal flap providing wide access to the dorsal surface of the wrist joint. After correction of the wrist deformity, skin triangles are resected on the radial and ulnar sides of the incision. Then the skin of the distal flap is slid radially and proximally, filling the defect left by the resected radial triangle, while the proximal flap is slid in the opposite direction, enabling transverse closure along the ulnar side of the incision. The final scar comprises a central body along the dorsal wrist crease, and a radial branch. The aim of this study was to analyze the clinical results of this new double Y sliding flap approach for the surgical treatment of type III and IV RLD. We retrospectively reviewed medical records of surgical correction of RLD using our new incision, between January 2016 and December 2018 in our department of hand surgery. Endpoints comprised correction of redundant skin, scar appearance, and complications. Twelve limbs in 9 patients treated with this double Y sliding flap approach were reviewed: correction of redundant skin was systematic, only 2 limbs showed postoperative complications (1 case of notable edema and 1 of delayed wound healing), and scar aspect was graded good in 11 of the 12 cases. The double Y sliding flap was safe, with minimal complications, adequate skin restoration, wide exposure of the wrist, and esthetically good scar. LEVEL OF EVIDENCE: IV.
摘要：
radial骨纵向缺陷（RLD）的手术治疗中的一个问题当然是皮肤切口。多年来,已经提出并使用了许多不同的类型。我们提出了一种新的皮肤切口技术：双Y滑动皮瓣，其主体沿着腕背折痕，然后抬起近端和远端皮瓣，可广泛进入腕关节的背侧。矫正手腕畸形后,在切口的桡侧和尺侧切除皮肤三角形。然后远端皮瓣的皮肤径向和近端滑动，填补切除的径向三角形留下的缺陷，当近侧翼沿相反方向滑动时，能够沿着切口的尺侧横向闭合。最终的疤痕包括沿着手腕背侧折痕的中央主体，和径向分支。这项研究的目的是分析这种新的双Y滑动皮瓣入路手术治疗III和IV型RLD的临床结果。我们回顾了使用我们的新切口手术矫正RLD的医疗记录，2016年1月至2018年12月在我们的手外科。终点包括多余皮肤的矫正，疤痕外观,和并发症。回顾了用这种双Y滑动皮瓣方法治疗的9例患者中的12条肢体：对多余的皮肤进行了系统的矫正，仅2条肢体出现术后并发症（1例明显水肿，1例伤口延迟愈合），12例中有11例瘢痕方面分级良好。双Y滑动皮瓣是安全的，以最小的并发症，足够的皮肤恢复，手腕的大面积暴露，和美观的疤痕。证据级别：IV.
