Thenar perforator flap combined with thumb dorsoulnar flap for repair of radial semicircular soft tissue defects of thumb

Abstract

Objective To investigate the method and clinical efficacy of thenar perforator flap combined with thumb dorsoulnar flap in the treatment of radial semicircular soft tissue defects of thumb. Methods From March 2013 to September 2016, 8 cases of radial semicircular soft tissue defects of thumb were treated by thenar perforator flap combined with thumb dorsoulnar flap. The area of thenar perforator flaps ranged from 3. 5 cm×2. 0 cm to 2. 5 cm×1. 5 cm for covering volar thumb defects. The area of thumb dorsoulnar flaps ranged from 3. 0 cm×2. 0 cm to 2. 5 cm×1. 5 cm for covering dorsal thumb defects. The donor sites were closed by full thickness skin graft. Results All 8 cases of skin flaps survived. Postoperative follow-up ranged from 6 to 12 months with an average of 9 months. The appearance, texture and color of the flaps were satisfactory. The sensation of thenar perforator flap recovered from S3to S3+, and the two-point discrimination recovered from 7 to 9 mm. The sensation of thumb dorsoulnar flap recovered from S2to S3, and the two-point discrimination recovered from 8 to 11 mm. There is no obvious effect on the shape and function of the donor sites. Conclusion It is a simple surgical method to repair radial semicircular soft tissue defects of thumb using thenar perforator flap combined with thumb dorsoulnar flap without damaging main vessels, which has satisfactory clinical efficacy. Key words: Thumb; Surgical flaps; Microsurgery; Soft tissue defects