Application of dorsal lobulated flap with toe extensor tendon graft to repair the finger skin and tendon tissue defect

GAN Gan-da; TANG Ji-quan; HU Ke-zhi; LUO Ping; TAO Zhi-gang

doi:10.3969/j.issn.1009-4237.2015.05.008

Abstract：Objective To investigate the clinical effect of dorsal lobulated flap with toe extensor tendon grafting in the repair of finger skin combined with tendon tissue defect.Methods Twelve patients (27 fingers) with multi-finger skin stretch and flexor tendon defect were admitted in our department from May 2011 to Oct.2013.According to the size and shape of the wounds,transplantation of medial foot flap,the first dorsal metatarsal flap and three-leaf flap of lateral foot were applied with the dorsal vessel designed as the backbone and medial tarsal vessel, the first dorsal metatarsal vessel and lateral vessel as the branch;or transplantation of the first dorsal metatarsal flap and double-leaf flap of lateral foot were applied with the first dorsal metatarsal vessel and lateral vessel as the branch.Flap with toe extensor tendon was cut for one-time repair of the skin defect associated with flexor and exten-sor tendon defects in 1 or 2 fingers.Results All transplanted flaps survived.Arterial crisis occurred in 3 cases, and 2 of them survived by treatment with intravenous anti-vascular spasm drugs,and the other survived by vascular exploration,excision of vascular segment and re-anastomosis of artery flap.All cases were followed up for 8-19 months.Their flap and texture were good.The flexion function was normal in 18 fingers,slightly restricted in 5 and obviously limited in 4.For skin and tendon of the donor foot,obvious scar contracture was not found and walking function was normal in all the patients.Conclusion Dorsal lobulated flap with toe extensor tendon grafting in the repair of finger skin combined with tendon tissue defect can achieve good looking and functional recovery.It is good for the repair of finger skin combined with tendon tissue defect.