The free twin-flap with the first metatarsal dorsal(bottom) artery repair the defects of distal in adjacent two fingers

Abstract

Objective To explore the clinical effect that the free twin-flap with the first dorsal (bottom) metatarsa artery repair the defects of distal in adjacent two fingers.Methods The twin-flap from the big toe and the second toe based on a single vascular pedicle of the firstl dorsal (bottom) metatarsa artery was designed in this article.From November 2010 to June 2013,this twin-flap was transferred in 9 patients.In order to solve the problems:the shortage of arterial span,the bone and (or)tendon exposed in the donor site,the thickness skin graft resurfaced in the donor site was not easy to survive,the bare vascular pedicle and the donor site were covered with artificial dermis for 3 weeks.After 3 weeks,cutting skin bridge and removing the thin of artificial dermis,the donor site was resurfaced by thickness skin graft.Results All cases were followed up for 4 to 12 months.All transfering flaps and the thickness skin graft were survival.The colours and texture of the flaps matched the recipient site.2-point discrimination ranged from 8 to 12 mm.Finger flexion and extension was satisfactory.The appearance of the donor site was well-stacked.No case had successive ulces,pain and car.Conclusion The twin-flap from the big toe and the second toe based on a single vascular pedicle of the first dorsal (bottom) metatarsal artery combined with artificial dermis to repair the defects of distal in adjacent two fingers.For one side,this operation can solve he shortage of arterial span and repair the defects of distal in adjacent two fingers at the same time.For another,it can provid a easy method for deal with the donor site and raise the survial rate of the thickness skin graft.Besides,it also is easy and safe,clinical effect is satisfaction. Key words: Finger injuries ; Toe ; First dorsal metatarsal artery; Transplantation ; Microsurgery