EFFECTIVENESS OF PART LONG THUMB EXTENSOR TENDON DORSAL ULNAR ARTERY CHIMERIC FLAP FOR REPAIR OF Doyle TYPE Ⅲ MALLET FINGER OF THUMB_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHOUXiao , RUIYongjun ,  XUEMingyu , XUYajun , QIANGLi

Department of Hand Surgery, Wuxi No. 9 People's Hospital, Hand Surgery Hospital of Wuxi, Wuxi Jiangsu, 214062, P. R. China;

Corresponding author：

XUEMingyu, Email: xuemingyu1010@sina.com

Keywords：

Thumb; Doyle type Ⅲ mallet finger; Tendon; Chimeric flap; Wound repair

DOI：

10.7507/1002-1892.20160190

Video：

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Objective To investigate the effectiveness of part long thumb extensor tendon dorsal ulnar artery chimeric flap for repair of Doyle type Ⅲ mallet finger of thumb. Methods Between June 2013 and April 2015, 9 cases of Doyle type Ⅲ mallet finger of thumb were treated, which were caused by planer injury. There were 6 males and 3 females, aged from 15 to 65 years (mean, 36 years). The time from injury to operation was 3-8 hours (mean, 5 hours). All cases had interphalangeal joint dorsal skin and soft tissue defects of the thumb; the skin defects ranged from 2.0 cm×1.5 cm to 2.3 cm×2.3 cm; the extensor tendon defect ranged from 0.5 to 1.5 cm in length (mean, 1.0 cm). The part long thumb extensor tendon dorsal ulnar artery chimeric flap of 3.0 cm×2.5 cm to 3.5 cm×3.0 cm in size was used to reconstruct extensor tendon and wound. The donor site was repaired with nasopharyngeal fossa perforating branches pedicled V-Y relay flap. Results All flaps survived completely and incisions healed by first intention. All patients were followed up 4-12 months (mean, 6 months). The flaps had good color, texture, and contour. At 6 months after operation, the two-point discrimination of chimeric flap was 10-12 mm (mean, 11 mm), and two-point discrimination of relay flap was 12-14 mm (mean, 13 mm). The interphalangeal joint flexion of thumb was 0-40°, and the thumb opposition function was normal. Conclusion Part long thumb extensor tendon dorsal ulnar artery chimeric flap can repair the Doyle type Ⅲ mallet finger of thumb, which has no injury to the artery and nerve. At the same time the relay flap can achieve linear healing, so good appearance and function of the thumb can be obtained.

Citation： ZHOUXiao, RUIYongjun, XUEMingyu, XUYajun, QIANGLi. EFFECTIVENESS OF PART LONG THUMB EXTENSOR TENDON DORSAL ULNAR ARTERY CHIMERIC FLAP FOR REPAIR OF Doyle TYPE Ⅲ MALLET FINGER OF THUMB. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(8): 939-942. doi: 10.7507/1002-1892.20160190 Copy

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10.	张智, 吴晓满, 陆俊峰, 等.掌长肌腱转移治疗陈旧性锤状指畸形.中国修复重建外科杂志, 2013, 27(6):726-728.
11.	朱立帆, 徐浩, 张晓剑, 等.锚钉修复法与改良缝合法治疗锤状指的疗效比较.中国修复重建外科杂志, 2012, 26(9):1077-1080.
12.	张文苹, 李文斌, 刘泽远, 等.改良加压石黑法治疗骨性锤状指的临床研究.中国修复重建外科杂志, 2016, 30(6):705-708.
13.	丁自海, 王增涛, 钟世镇.皮瓣解剖学研究的三个阶段.中华显微外科杂志, 2010, 33(3):180-181.
14.	芮永军, 徐建光, 顾玉东.以上肢浅表皮神经伴行血管为蒂的岛状皮瓣的解剖学研究.中华手外科杂志, 1997, 13(4):226-230.
15.	刘毅, 张诚, 蔡黔, 等.接力皮瓣修复足部远端皮肤缺损.中国综合临床, 2003, 19(5):469.

1. 田光磊, 蒋协远, 陈山林, 主译.格林手外科手术学. 6版.北京:人民军医出版社, 2012:155-156.
2. 佟长贵, 童致虹, 梁海东, 等.指固有动脉背侧穿支螺旋桨皮瓣修复指端缺损.中国修复重建外科杂志, 2016, 30(5):657-658.
3. 杨焕友, 杨振建, 贾松, 等.指血管神经肌腱移位一期再植治疗拇指旋转撕脱离断.中国修复重建外科杂志, 2016, 30(3):394-395.
4. Little JW. Neurovascular pedicle transfer of tissue in reconstructive surgery of the hand(revlewl). Bone J Surg, 1995, 38:17-21.
5. Zhou X, Wang L, Mi J, et al. Thumb fingertip reconstruction with palmar V-Y flaps combined with bone and nail bed grafts following amputation. Arch Orthop Trauma Surg, 2015, 135(4):589-594.
6. 潘达德, 顾玉东, 侍德, 等.中华医学会手外科学会上肢部分功能评定试用标准.中华手外科杂志, 2000, 16(3):130-135.
7. 周晓, 芮永军, 薛明宇, 等.逆行拇桡侧指背动脉筋膜蒂掌骨皮瓣修复拇指末节复合组织缺损.中华骨科杂志, 2013, 33(11):1104-1108.
8. Neuhaus V, Thomas MA, Mudgal CS. Type Ⅱb bony mallet finger:is anatomical reduction of the fracture necessary? Am J Orthop (Belle Mead NJ), 2013, 42(5):223-226.
9. Miranda BH, Murugesan L, Grobbelaar AO, et al. PBNR: Percutaneous blunt needle reduction of bony mallet injuries. Tech Hand Up Extrem Surg, 2015, 19(2):81-83.
10. 张智, 吴晓满, 陆俊峰, 等.掌长肌腱转移治疗陈旧性锤状指畸形.中国修复重建外科杂志, 2013, 27(6):726-728.
11. 朱立帆, 徐浩, 张晓剑, 等.锚钉修复法与改良缝合法治疗锤状指的疗效比较.中国修复重建外科杂志, 2012, 26(9):1077-1080.
12. 张文苹, 李文斌, 刘泽远, 等.改良加压石黑法治疗骨性锤状指的临床研究.中国修复重建外科杂志, 2016, 30(6):705-708.
13. 丁自海, 王增涛, 钟世镇.皮瓣解剖学研究的三个阶段.中华显微外科杂志, 2010, 33(3):180-181.
14. 芮永军, 徐建光, 顾玉东.以上肢浅表皮神经伴行血管为蒂的岛状皮瓣的解剖学研究.中华手外科杂志, 1997, 13(4):226-230.
15. 刘毅, 张诚, 蔡黔, 等.接力皮瓣修复足部远端皮肤缺损.中国综合临床, 2003, 19(5):469.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF PART LONG THUMB EXTENSOR TENDON DORSAL ULNAR ARTERY CHIMERIC FLAP FOR REPAIR OF Doyle TYPE Ⅲ MALLET FINGER OF THUMB

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