PDF(Pubmed)
Abstract：
BACKGROUND: Soft tissue defects in the hand may result from trauma, oncological procedures, or severe infections. This study aimed to introduce an innovative method for repairing soft tissue defects on the palmar side of the distal segment of the affected finger or fingertip. We explored this surgical method and its curative effect on the volar rotation pedicled flap base on a perforator of the palmar digital artery (VRPF-PPDA) for repairing ventral or fingertip soft tissue defects of the distal segment of the affected finger without impairing its main blood vessels.
METHODS: Between June 2019 and January 2021, 13 patients with finger pulp or fingertip soft tissue defects were treated with VRPF-PPDA. Flap survival rate, complication rate, two-point discrimination (2PD), and patient satisfaction were used to evaluate the efficacy of this method. The function of the affected finger was evaluated using the upper limb function evaluation method issued by the Trial Standards for Evaluation of Partial Function of the Upper Extremity of the Chinese Society for Surgery of the Hand of the Chinese Medical Association (CMA) and the Disabilities of the Arm, Shoulder, and Head (DASH) score, 6-12 months after the flap-based operation.
RESULTS: Thirteen patients (18 fingers) achieved complete flap survival. The finger pulp flap was full, and no complications occurred. 2PD checks of the flaps revealed that all of them were 4-10 mm in length. According to the Trial Standards for Evaluation of Partial Function of the Upper Extremity of the Chinese Society for Surgery of the Hand of the CMA, hand function was excellent in 12 patients (17 fingers) and good in one patient, with a mean DASH score of 26.05 ± 0.45. Eleven patients selected \"excellent\" on the subjective satisfaction survey, while the other two selected \"good.\"
CONCLUSIONS: VRPF-PPDA surgery is a simple, effective, minimally invasive, and reliable method for repairing soft tissue defects in the distal finger pulp or fingertips. Optimal esthetic reconstruction and anatomical and functional repair can be achieved in fingers repaired using the VRPF-PPDA surgical approach.
METHODS: Between June 2019 and January 2021, 13 patients with finger pulp or fingertip soft tissue defects were treated with VRPF-PPDA. Flap survival rate, complication rate, two-point discrimination (2PD), and patient satisfaction were used to evaluate the efficacy of this method. The function of the affected finger was evaluated using the upper limb function evaluation method issued by the Trial Standards for Evaluation of Partial Function of the Upper Extremity of the Chinese Society for Surgery of the Hand of the Chinese Medical Association (CMA) and the Disabilities of the Arm, Shoulder, and Head (DASH) score, 6-12 months after the flap-based operation.
RESULTS: Thirteen patients (18 fingers) achieved complete flap survival. The finger pulp flap was full, and no complications occurred. 2PD checks of the flaps revealed that all of them were 4-10 mm in length. According to the Trial Standards for Evaluation of Partial Function of the Upper Extremity of the Chinese Society for Surgery of the Hand of the CMA, hand function was excellent in 12 patients (17 fingers) and good in one patient, with a mean DASH score of 26.05 ± 0.45. Eleven patients selected \"excellent\" on the subjective satisfaction survey, while the other two selected \"good.\"
CONCLUSIONS: VRPF-PPDA surgery is a simple, effective, minimally invasive, and reliable method for repairing soft tissue defects in the distal finger pulp or fingertips. Optimal esthetic reconstruction and anatomical and functional repair can be achieved in fingers repaired using the VRPF-PPDA surgical approach.
摘要：
背景：手部软组织缺损可能是外伤造成的，肿瘤手术,或严重感染。这项研究旨在介绍一种创新的方法，用于修复受影响的手指或指尖远节的掌侧软组织缺损。我们探讨了这种手术方法及其在掌指动脉穿支（VRPF-PPDA）上的掌侧旋转带蒂皮瓣（VRPF-PPDA）上修复患指远端腹侧或指尖软组织缺损而不损害其主要血管的疗效。
方法：在2019年6月至2021年1月期间，对13例指腹或指尖软组织缺损患者进行VRPF-PPDA治疗。皮瓣成活率,并发症发生率,两点判别(2PD)，和患者满意度用于评估该方法的疗效。采用中华医学会(CMA)《中华手外科学会上肢部分功能评价试行标准》和《手臂残疾》颁布的上肢功能评价方法,对患指进行功能评价,肩膀,和头部（DASH）得分，术后6-12个月皮瓣为主的手术。
结果：13例患者（18指）获得了完整的皮瓣存活。指腹瓣满了,无并发症发生。皮瓣的2PD检查显示它们的长度均为4-10mm。根据中国CMA手外科学会上肢部分功能评价试行标准,12例患者（17指）手功能良好，1例患者手功能良好，平均DASH评分为26.05±0.45。在主观满意度调查中选择“优秀”的11名患者，而另外两个人选择了“好”。\"
结论：VRPF-PPDA手术很简单，有效,微创,和可靠的方法，用于修复远端指腹或指尖的软组织缺损。使用VRPF-PPDA手术方法修复的手指可以实现最佳的美学重建以及解剖和功能修复。
方法：在2019年6月至2021年1月期间，对13例指腹或指尖软组织缺损患者进行VRPF-PPDA治疗。皮瓣成活率,并发症发生率,两点判别(2PD)，和患者满意度用于评估该方法的疗效。采用中华医学会(CMA)《中华手外科学会上肢部分功能评价试行标准》和《手臂残疾》颁布的上肢功能评价方法,对患指进行功能评价,肩膀,和头部（DASH）得分，术后6-12个月皮瓣为主的手术。
结果：13例患者（18指）获得了完整的皮瓣存活。指腹瓣满了,无并发症发生。皮瓣的2PD检查显示它们的长度均为4-10mm。根据中国CMA手外科学会上肢部分功能评价试行标准,12例患者（17指）手功能良好，1例患者手功能良好，平均DASH评分为26.05±0.45。在主观满意度调查中选择“优秀”的11名患者，而另外两个人选择了“好”。\"
结论：VRPF-PPDA手术很简单，有效,微创,和可靠的方法，用于修复远端指腹或指尖的软组织缺损。使用VRPF-PPDA手术方法修复的手指可以实现最佳的美学重建以及解剖和功能修复。
