Operative Orthopadie und Traumatologie · 2020
[Moschella island flap for coverage of thumb defects].
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Homann Heinz-Herbert, Gojowy David, Sacher Maxi, Schreier Detlef
Аннотация
OBJECTIVE: The homodigital island flap according to Moschella is used to cover palmar and radiodorsal soft tissue defects of the thumb.
INDICATIONS: Soft tissue reconstruction of the thumb with exposed bone and/or tendon if reconstruction of the soft tissue is required.
CONTRAINDICATIONS: Extensive scars in the harvesting area of the flap; vascular occlusions of the radial artery.
SURGICAL TECHNIQUE: After Doppler sonographic imaging of the origin of the vessel radially at the thumb, the pivot point is determined. The flap is then cut from ulnar to radial, including the dorsoradial artery of the thumb. Removal of the origin of the vessel from the radial artery in the tabatiére and preparation from proximal to distal to the pivot point of the flap at the junction of the artery with the palmar vessels. If necessary, a part of the skin can remain palmar to the pivot point to improve venous drainage. The donor site of the flap can primarily close defect sizes up to 5 × 4 cm.
POSTOPERATIVE MANAGEMENT: Until wound healing, soft cotton dressing should protect the vascular pedicle from pressure; immobilisation on a palmar splint may be helpful.
RESULTS: In 9 men, sufficient soft tissue reconstruction of thumb defects could be achieved with the described Moschella flap. Eight patients had additional injuries to the fingers and hand.
INDICATIONS: Soft tissue reconstruction of the thumb with exposed bone and/or tendon if reconstruction of the soft tissue is required.
CONTRAINDICATIONS: Extensive scars in the harvesting area of the flap; vascular occlusions of the radial artery.
SURGICAL TECHNIQUE: After Doppler sonographic imaging of the origin of the vessel radially at the thumb, the pivot point is determined. The flap is then cut from ulnar to radial, including the dorsoradial artery of the thumb. Removal of the origin of the vessel from the radial artery in the tabatiére and preparation from proximal to distal to the pivot point of the flap at the junction of the artery with the palmar vessels. If necessary, a part of the skin can remain palmar to the pivot point to improve venous drainage. The donor site of the flap can primarily close defect sizes up to 5 × 4 cm.
POSTOPERATIVE MANAGEMENT: Until wound healing, soft cotton dressing should protect the vascular pedicle from pressure; immobilisation on a palmar splint may be helpful.
RESULTS: In 9 men, sufficient soft tissue reconstruction of thumb defects could be achieved with the described Moschella flap. Eight patients had additional injuries to the fingers and hand.