Application of the distal ulnar perforator minitype flap with anastomosed sensory nerve to repair the full pulp defect
WU Jian-long, XIE Qing-ping, TANG Lin-feng, JU Ji-hui
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (5) : 565-568.
Application of the distal ulnar perforator minitype flap with anastomosed sensory nerve to repair the full pulp defect
Objective To introduce the surgical effect of free transplantation of distal ulnar perforator minitype flap with sensory nerve to repair finger pulp soft tissue defect. Methods From April 2006 to February 2012 in our hospital, 32 patients, including 34 fingers, with finger pulp soft tissue defect were repaired by free transplantation of forearm distal perforator flap with sensory nerve. The area of skin flaps differed from1.5 cm×2.0 cm to 3.0 cm×4.5 cm. Results 1 case had partial necrosis of distal flap after operation, and the scabs healed after dressing change. The remaining 31 cases all survived. Except for 5 cases of grafted skin for survival, the remaining donor sites were directly sutured, and healed well without obvious scar contracture. Follow-up ranged from 6 to 36 months with an average of 16 months, and the shape and function of the fingers were restored satisfactorily. The outcomes were graded as excellent in 26 cases, good in 5 cases, and fair in 1 case according to the functional assessment criteria for upper extremities issued by the Hand Society of the Chinese Medical Association. Achieving a 96.8% good and excellent rate. Two-point discrimination of the flaps was 6 to 12 mm. Conclusion The forearm distal ulnar perforator has constant perforating point, which carry sensory nerves to repair finger pulp defects. The texture of the skin flap is close to the affected area, the shape of finger recoverd well, the flap sensation recovery is good. The distal ulnar perforator minitype flap with sensory nerve is one of the effective surgical procedures to repair the defect of finger pulp.
Perforator flap; Minitype flap; / Sensory nerve; / Finger injury; / Repair
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