Comparison between modified anterolateral thigh flap and abdominal pedicle flap in the re-pair of hand soft tissue defects

Wang Shaoqian; Wang Hui; Jia Qiyu

doi:10.3969/j.issn.1009-4237.2025.07.004

Abstract：Objective To compare the application effect of modified anterolateral thigh flap and abdominal pedicle flap in the repair of hand soft tissue defects.Methods A retrospective study was conducted on clinical data of 100 cases of hand injuries with soft tissue defects admitted to our hospital from Jan.2021 to Aug.2023,including 57 males and 43 females.The age ranged from 28 to 51 years,38.8 years on average.According to different donor sites of the flaps,patients were divided into the modified anterolateral thigh flap group(n=49:29 males and 20 fe-males aged 28-45 years,mean 38.6 years,with 12 injuries due to bruise,10 to cut,9 to twist,15 to crush,and 3 to others)and the abdominal pedicle flap group(n=51,28 males and 23 females aged 29-51 years,mean 39.1 years,with 10 injuries due to bruise,11 to cut,8 to twist,17 to crush,and 5 to others).The final clinical efficacy was com-pared between the two groups at postoperative 12 months.The changes in hand sensory function were evaluated at 2 d and 3,6,and 12 months after surgery by monofilament method,which assessed the flap pressure sensation depen-ding on the diameter of the nylon filament:the larger the diameter,the worse the hand sensory.The Michigan Hand Function(MHQ)score was also adopted to assess the hand function before and 3,6,and 12 months after surgery.Postoperative complications were recorded.Results For all patients after treatment,the hand sensory and functions were significantly improved with time:the diameter of the nylon filament continually became smaller and the MHQ score continually became larger of either group(all P<0.05,compared with the same group any time point earlier).Moreover,comparison between the modified anterior lateral thigh flap group and the abdominal pedicle flap group showed much better results in the former:(1)much higher excellent and good rate at 12 months after surgery(98.0%vs.78.4%,P<0.05);much smaller diameter(mm)of the nylon filament at 3 months(4.2±0.2 vs.4.9±0.3),6 months(3.0±0.2 vs.3.9±0.4),and 12 months(2.2±0.1 vs.2.9±0.1)after surgery(all P<0.05);(3)much higher MHQ scores at 3 months(66.0±5.1 vs.59.8±5.3),6 months(76.3±4.5 vs.70.6±5.2),and 12 months(85.7±3.6 vs.80.1±4.1)after surgery(all P<0.05).Moreover,the incidence of postoperative compli-cations revealed no significant difference(2.0%vs.9.8%,P>0.05).Conclusion Both the two donor site flaps can well repair hand soft tissue defects,but the modified anterolateral thigh flap can promote the recovery of hand sensation and overall function without increasing the risk of complications.