Sequential adjacent finger flap combined with thenar flap to repair the old multiple fingertip soft tissue defects

ZHANG Cheng; SUN De-lin; LI Cheng-li; KANG Le; QU Jun-jie; MENG Yong-chun; XU Lin

doi:10.3969/j.issn.1009-4237.2018.06.003

Abstract：Objective To explore the surgical treatment of the old multiple fingertip soft tissue defects. Methods From Jan.2012 to Jun.2017,the materials were collected from the clinical application of sequential ad-jacent finger flap combined with thenar flap to repair 12 patients with old multiple fingertip soft tissue defects in Yantai Affiliated Hospital of Binzhou Medical University.Among them,there were 8 male patients and 4 female pa-tients.Their age was from 35 to 56,with an average age of 47.3.Causes of injury included 5 cases of electric saw injury,4 cases of heavy crush injury ,2 cases of avulsion injury ,and 1 case of frostbite.All of them suffered from the fingertip soft tissue defects of multiple fingers (more than 2 fingers,except thumb) in different degrees.The defect range was 0.5×1.3cm-1.4×2.3cm.The X-ray examination of all patients before operation showed that there were various defects of the fingertip soft tissue or bone in different degrees.According to the size of the skin soft tissue defect,the skin flap was designed and the flap at greater thenar site was cut for repair ,and the adjacent injured fin-gers were repaired with thenar flap.After operation,12 patients were followed up regularly to observe the appear-ance,function,sensation and survival of the flaps.Results The flaps of 12 cases all survived after operation ,and all wounds acquired primary healing.The patients were followed up for 3 months to 2 years by means of clinical re-examination and telephone ,with an average follow-up of 1.4 years.The transplanted skin flaps had completely cov-ered the defect.No necrosis,abrasion or ulceration occurred ,neither did scar contracture.Besides,the sensory func-tion had recovered to some extent.The patients were satisfied with the transplanted flaps.Conclusion It is a fea-sible method that the sequential adjacent finger flap combined with thenar flap repair old multiple fingertip soft tissue defects,which has the advantages of simple operation ,beautiful appearance ,retaining the finger length ,no need for microsurgical technique ,high survival rate and good function.