Abstract
Objective To compare the surgical results of different configurations of reverse superficial radial nerve neurocutaneous flap on dorsoulnar aspect of the thumb in repairing soft tissue defects of the thumb.Methods A total of 31 cases of soft tissue defects of the thumb were treated with reverse superficial radial nerve neurocutaneous flap on dorsoulnar aspect of the thumb.In 11 cases (group A) only a narrow fascia pedicle was retained without including a substantial dorsal vein in the flap.In 20 cases (group B) a wider fascia pedicle was designed to include a continuous,thick dorsal vein.Results Postoperative venous congestion occurred in 3 cases of group A causing the flaps to turn purple.The congestion subsided in 3 to 4 days.Partial skin necrosis was found in one of these cases.No venous congestion was noted in group B.All the flaps survived uneventfully.Conclusion Including a continuous,thick dorsal vein within the fascia pedicle can significantly reduce postoperative venous congestion and improve flap survival. Key words: Surgical flaps; Thumb; Superficial branch of the radial nerve nutrient vessels; Soft tissue defects
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