Abstract：
OBJECTIVE: To explore a surgical method for the reconstruction of volar soft tissue defect and sensory and vascular repair in middle and far phalangeal digits.
METHODS: From January 2016 to January 2020, a total of 14 patients , 9 males and 5 females, ages ranging from 22 to 69 years old, and with volar soft tissue defects in the middle and distal digits 2 to 4, underwent surgical reconstruction using the V-Y shaped flap with digital artery and nerve at the metacarpophalangeal joint. The defect area was (2.0~2.5) cm×(1.5 ~2.0) cm. The procedure involved the harvest of a V-Y shaped flap with the digital artery and nerve from the metacarpophalangeal joint. Flap design, dissection of blood vessels and nerves, and anastomosis with the digital artery and nerve were performed according to a standardized protocol., Functional exercise of affected finger was initiated 3 weeks postoperatively. Subsequent assessments were conducted to evaluate finger pulp sensation, shape and other relevant parameters. According to the upper extremity functional evaluation standard set up by Hand Surgery Branch of Chinese Medical Association, the surgical outcomes were evaluated.
RESULTS: All 14 cases demonstrated successful tissue transplantation, , with immediate recovery of sensation observed in 10 cases with distal finger pulp defects. Four patients with middle phalangeal defects experienced gradual sensory recovery within 2 to 3 months postoperatively. Thirteen patients were followed up for a mean duration of (8.8 ± 4.49) months, during which satisfactory outcomes were observed. The average two-point resolution of the finger pulp was 4-6mm, and sensory function evaluation yielded a score of S3 or above. Patients exhibited realistic finger shape, normal skin color and temperature, good wear resistance, and cold resistance. Furthermore, finger joint function was essentially normal.
CONCLUSIONS: The V-Y shaped flap with digital artery and nerve at the metacarpophalangeal joint offers a suitable solution for repairing the defect of the middle or distal phalangeal finger. This technique is characterized by its simplicity, low risk, and favorable outcomes, including restored finger shape, blood supply and sensation. Moreover, high patient satisfaction was achieved.
METHODS: From January 2016 to January 2020, a total of 14 patients , 9 males and 5 females, ages ranging from 22 to 69 years old, and with volar soft tissue defects in the middle and distal digits 2 to 4, underwent surgical reconstruction using the V-Y shaped flap with digital artery and nerve at the metacarpophalangeal joint. The defect area was (2.0~2.5) cm×(1.5 ~2.0) cm. The procedure involved the harvest of a V-Y shaped flap with the digital artery and nerve from the metacarpophalangeal joint. Flap design, dissection of blood vessels and nerves, and anastomosis with the digital artery and nerve were performed according to a standardized protocol., Functional exercise of affected finger was initiated 3 weeks postoperatively. Subsequent assessments were conducted to evaluate finger pulp sensation, shape and other relevant parameters. According to the upper extremity functional evaluation standard set up by Hand Surgery Branch of Chinese Medical Association, the surgical outcomes were evaluated.
RESULTS: All 14 cases demonstrated successful tissue transplantation, , with immediate recovery of sensation observed in 10 cases with distal finger pulp defects. Four patients with middle phalangeal defects experienced gradual sensory recovery within 2 to 3 months postoperatively. Thirteen patients were followed up for a mean duration of (8.8 ± 4.49) months, during which satisfactory outcomes were observed. The average two-point resolution of the finger pulp was 4-6mm, and sensory function evaluation yielded a score of S3 or above. Patients exhibited realistic finger shape, normal skin color and temperature, good wear resistance, and cold resistance. Furthermore, finger joint function was essentially normal.
CONCLUSIONS: The V-Y shaped flap with digital artery and nerve at the metacarpophalangeal joint offers a suitable solution for repairing the defect of the middle or distal phalangeal finger. This technique is characterized by its simplicity, low risk, and favorable outcomes, including restored finger shape, blood supply and sensation. Moreover, high patient satisfaction was achieved.
摘要：
目的：探讨重建掌侧软组织缺损及中远指骨感觉血管修复的手术方法。
方法：2016年1月至2020年1月，共14例患者，9男5女,年龄从22岁到69岁，并在2至4的中指和远端指掌软组织缺损，使用V-Y形皮瓣在掌指关节处具有指动脉和神经。缺损面积为(2.0~2.5)cm×(1.5~2.0)cm。该程序涉及从掌指关节收获带有指动脉和神经的V-Y形皮瓣。襟翼设计,血管和神经的解剖，并根据标准化方案进行了与指动脉和神经的吻合。,术后3周开始患指功能锻炼。随后进行评估以评估指腹感觉，形状和其他相关参数。根据中华医学会手外科分会制定的上肢功能评价标准,评估手术结果.
结果：所有14例患者均显示成功的组织移植，,在10例远端指髓缺损中观察到感觉立即恢复。四名中指骨缺损患者在术后2至3个月内经历了逐渐的感觉恢复。13例患者均获随访,平均随访时间(8.8±4.49)个月,在此期间观察到令人满意的结果。指腹的平均两点分辨率为4-6mm，和感官功能评估产生S3或以上的分数。患者表现出逼真的手指形状，正常的皮肤颜色和温度，良好的耐磨性，和耐寒。此外，手指关节功能基本正常。
结论：掌指关节处带有指动脉和神经的V-Y形皮瓣为修复指中或远端指骨缺损提供了合适的解决方案。这种技术的特点是它的简单，低风险,和有利的结果，包括恢复手指形状，血液供应和感觉。此外，患者满意度较高。
方法：2016年1月至2020年1月，共14例患者，9男5女,年龄从22岁到69岁，并在2至4的中指和远端指掌软组织缺损，使用V-Y形皮瓣在掌指关节处具有指动脉和神经。缺损面积为(2.0~2.5)cm×(1.5~2.0)cm。该程序涉及从掌指关节收获带有指动脉和神经的V-Y形皮瓣。襟翼设计,血管和神经的解剖，并根据标准化方案进行了与指动脉和神经的吻合。,术后3周开始患指功能锻炼。随后进行评估以评估指腹感觉，形状和其他相关参数。根据中华医学会手外科分会制定的上肢功能评价标准,评估手术结果.
结果：所有14例患者均显示成功的组织移植，,在10例远端指髓缺损中观察到感觉立即恢复。四名中指骨缺损患者在术后2至3个月内经历了逐渐的感觉恢复。13例患者均获随访,平均随访时间(8.8±4.49)个月,在此期间观察到令人满意的结果。指腹的平均两点分辨率为4-6mm，和感官功能评估产生S3或以上的分数。患者表现出逼真的手指形状，正常的皮肤颜色和温度，良好的耐磨性，和耐寒。此外，手指关节功能基本正常。
结论：掌指关节处带有指动脉和神经的V-Y形皮瓣为修复指中或远端指骨缺损提供了合适的解决方案。这种技术的特点是它的简单，低风险,和有利的结果，包括恢复手指形状，血液供应和感觉。此外，患者满意度较高。
