Anastomosis of dorsal branch of the proper digital nerve dorsal distal interphalangeal joint perforator flap to repair finger tip defect of skin tissue

Abstract

Objective To Summarize the application of digital artery dorsal distal interphalangeal joint perforator flap to repair finger tip skin defect, and at the same time, the method and effect of anastomosis of finger dorsal branch of digital nerve sensory reconstruction. Methods From September 2012 to March 2015, 78 patients 92 fingers were treated in Orthopedics Department of Jinshan Branch Hospital of the Sixth People′s Hospital of Shanghai, all patients with finger artery distal interphalangeal joint dorsal cutaneous branches of the dorsal flap pedicled with retrograde, transferred to repair the skin defect of finger end, and anastomosis of dorsal branch of the proper digital nerve reconstruction. Results Postoperative vascular crisis occurred in 8 cases, 2 cases of partial flap necrosis and healed after symptomatic treatment.All flaps survived, the wounds healed in I stage, and the donor site healed in I stage.All the 73 cases were followed up, the follow-up period ranged from 3.0 to 12.0 months, an average of (7.8±2.5) months.The postoperative appearance and feel good, soft texture, abrasion resistance, no tenderness, cold resistance, dynamic two-point recovered to 4.0-8.0 mm, average (5.3±0.9) mm.Static two-point discrimination was 4.0-9.0 mm, average (5.8±1.2) mm.The method of TAM was used to determine the function of the 67 fingers, good for the 7 finger, but also for the 5 finger and the difference of the 0 finger.The excellent and good rate was up to 93.7%. Conclusion The operation without sacrifice of major arteries and nerves by finger, the middle finger dorsal skin for non functional surface area, and at the same time by anastomosis of dorsal branch of the proper digital nerve reconstruction, without surgery two times, is one of the ideal surgical repair of skin defect of the finger end. Key words: Dorsal branch of digital artery; Perforator flap; Skin defect of finger end; Refers to the inherent nerve