Zhongguo gu shang = China journal of orthopaedics and traumatology · 2026
[Clinical observation on combined repair of avulsion injury of the distal phalanx of the finger with dorsalis branch of digital artery flap and cross-finger flap].
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Zhao Huimin, Zhao Guangyuan
Аннотация
OBJECTIVE: To investigate the clinical efficacy of combined dorsalis branch of digital artery flap and cross-finger flap in the repair of avulsion injury of the distal phalanx of the finger.
METHODS: Between March 2019 and June 2023, 13 patients with degloving injury of the distal phalanx of the finger or amputated finger without replantation conditions were treated with combined homodigital dorsalis branch of digital artery flap and cross-finger flap, including 11 males and 2 females, aged from 21 to 55 years old. Among them, 6 cases were complicated with distal phalanx fracture. The injury level was all distal to the distal interphalangeal joint, and the defect area ranged from 2.0 cm×3.4 cm to 3.3 cm×4.1 cm. The time from injury to surgery was 2.5 to 8.0 hours.
RESULTS: All flaps survived in the 13 patients, with a follow-up period ranging from 6 to 8 months. At the final follow-up, the flaps had a plump appearance without significant scar contracture. The active flexion and extension of the interphalangeal joints of the injured fingers were good without restriction. The two-point discrimination distance of the flaps was 4 to 9 mm;sensory recovery reached S2 grade in 7 cases and S3+ grade in 6 cases. The clinical efficacy was evaluated according to the Trial Criteria for Upper Extremity Functional Assessment of the Chinese Society for Hand Surgery, with 10 cases rated as excellent and 3 as good.
CONCLUSION: Combination of the homodigital dorsalis branch of digital artery flap with the cross-finger flap for repairing degloving injury of the distal phalanx of the finger is a combination of traditional flaps, which has the capability of three-dimensional reconstruction, causes minimal tissue damage at the flap donor site, and conforms to the principle of "prioritizing simplicity over complexity" in flap therapy.
METHODS: Between March 2019 and June 2023, 13 patients with degloving injury of the distal phalanx of the finger or amputated finger without replantation conditions were treated with combined homodigital dorsalis branch of digital artery flap and cross-finger flap, including 11 males and 2 females, aged from 21 to 55 years old. Among them, 6 cases were complicated with distal phalanx fracture. The injury level was all distal to the distal interphalangeal joint, and the defect area ranged from 2.0 cm×3.4 cm to 3.3 cm×4.1 cm. The time from injury to surgery was 2.5 to 8.0 hours.
RESULTS: All flaps survived in the 13 patients, with a follow-up period ranging from 6 to 8 months. At the final follow-up, the flaps had a plump appearance without significant scar contracture. The active flexion and extension of the interphalangeal joints of the injured fingers were good without restriction. The two-point discrimination distance of the flaps was 4 to 9 mm;sensory recovery reached S2 grade in 7 cases and S3+ grade in 6 cases. The clinical efficacy was evaluated according to the Trial Criteria for Upper Extremity Functional Assessment of the Chinese Society for Hand Surgery, with 10 cases rated as excellent and 3 as good.
CONCLUSION: Combination of the homodigital dorsalis branch of digital artery flap with the cross-finger flap for repairing degloving injury of the distal phalanx of the finger is a combination of traditional flaps, which has the capability of three-dimensional reconstruction, causes minimal tissue damage at the flap donor site, and conforms to the principle of "prioritizing simplicity over complexity" in flap therapy.