Progressive subcutaneous pedicle double V-Y flap combined with surgery of nail bed augmentation to repair the transverse defect of fingertip and nail bed defect

doi:10.13418/j.issn.1001-165x.2022.1.15

PDF(1738 KB)

Chinese Journal of Clinical Anatomy ›› 2022, Vol. 40 ›› Issue (1) : 78-80. DOI: 10.13418/j.issn.1001-165x.2022.1.15

Progressive subcutaneous pedicle double V-Y flap combined with surgery of nail bed augmentation to repair the transverse defect of fingertip and nail bed defect

Li Shujun1, Chang Shusen1, Wang Dali1, Jin Wenhu1, Sun Guangfeng2, Wei Zairong1*

Author information +

History +

Abstract

Objective To investigate the clinical effect of progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation in the repair the transverse defect of fingertip and partial nail bed defect. Methods From June 2015 to June 2019, 17 patients with transverse defect of fingertip and nail bed defect were treated with progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation. The area of the affected finger wound was 1.0 cm× 0.8 cm ~ 1.6 cm× 1.5 cm. The fingers were followed-up in function, appearance and incidence of hook nail deformity. Results The postoperative follow-up period was 8 to 24 months, 13 months on average. All the 19 flaps survived well. The sensory recovery of 19 flaps reached S4 grade. The reconstructive fingers formed arc-shaped fingertips with nails of good appearance and texture. The appearance of the fingers was satisfactory and the joint movement was normal. The length of the nail bed increased by 2~4 mm, 3.3 mm on average. There was no hook nail deformity in each finger. The excellent rate of nail regeneration was 94%. Conclusions Progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation can repair the transverse defect of fingertip and nail bed defect, and reduce the incidence of hook nail deformity while reconstructing the shape of fingertip and nail. It is an effective and simple surgical method for injured finger to reconstruct the shape and function to the maximum extent.

Key words

Finger injures; / / Surgical flap; / / Defect; / / Nail deformity

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

Li Shujun, Chang Shusen, Wang Dali, Jin Wenhu, Sun Guangfeng, Wei Zairong. Progressive subcutaneous pedicle double V-Y flap combined with surgery of nail bed augmentation to repair the transverse defect of fingertip and nail bed defect[J]. Chinese Journal of Clinical Anatomy. 2022, 40(1): 78-80 https://doi.org/10.13418/j.issn.1001-165x.2022.1.15

References

[1] Panattoni JB, De Ona IR, Ahmed MM. Reconstruction of fingertip injuries: surgical tips and avoiding complications[J]. J Hand Surg Am, 2015, 40(5): 1016-1024. DOI: 10.1016/j.jhsa.2015.02.010.
[2] Sindhu K, DeFroda SF, Harris AP, et al. Management of partial fingertip amputation in adults: operative and non operative treatment[J].Injury, 2017, 48(12): 2643-2649. DOI: 10.1016/j.injury. 2017. 10.042.
[3] 侯春林, 顾玉东. 皮瓣外科学[M]. 上海: 上海科学技术出版社, 2006: 515-516, 534.
[4] 林涧, 余云兰, 王正理, 等. 甲床延长术的临床应用研究[J]. 实用骨科杂志, 2008, 14(1): 43-44. DOI: 10.3969/j.issn.1008-5572.2008.01.018.
[5] 王瑞, 苗平, 葛华平, 等. 断层甲床移植在修复手指甲床部分缺损中的疗效[J]. 实用手外科杂志, 2016, 30(2): 169-170, 200. DOI: 10.3969/j.issn.1671-2722.2016.02.015.
[6] 王利, 杨涛, 李文庆, 等. 指甲扩大术的解剖学基础[J]. 中国临床解剖学杂志, 2003, 21(3): 245-246. DOI: 10.3969/j.issn.1001-165X.2003. 03.019.
[7] 张涛, 张勇. 自体指(趾)甲甲模在炎症性拔甲术后的应用[J]. 中华整形外科杂志, 2004, 20(3): 183. DOI: 10.3760/j.issn:1009-4598.2004. 03.026.
[8] 潘生德, 顾玉东, 侍德. 中华医学会手外科学会上肢部分功能评定试用标准[J]. 中华手外科杂志, 2000, 16(3): 130. DOI: 10.3760/cma.j.issn.1005-054X.2000.03.003.
[9] 李宝山, 章雪松, 杨飞, 等. 矩形推进皮瓣及甲床扩大成形术治疗合并指甲部分缺失的指远端损伤[J]. 中华手外科杂志, 2002, 18(3): 151-152. DOI: 10.3760/cma.j.issn.1005-054X.2002.03.010.
[10]Miller AJ, Rivlin M, Kirkpatrick W, et al. Fingertip amputation treatment: a survey study[J]. Am J Orthop(Belle Mead NJ), 2015, 44(9): E331-E339.
[11] 李海, 魏在荣, 孙广峰, 等. 带感觉指固有动脉穿支V-Y推进皮瓣修复手指软组织缺损的临床应用[J]. 中华手外科杂志, 2018, 34(6): 401-403. DOI: 10.3760/cma.j.issn.1005-054X.2018.06.001.
[12]Sungur N, Kankaya Y, Yildiz K, et al. Bilateral V-Y rotation advancement flap for fingertip amputations[J]. Hand, 2012, 7(1): 79-85. DOI: 10.1007/s11552-011-9389-6.
[13] Regmi S, Gu J, Zhang N, et al. A systematic review of outcomes and complications of primary fingertip reconstruction using reverse-flow homodigital island flaps[J]. Aesthetic Plast Surg, 2016, 40(2): 277-283. DOI: 10.1007/s00266-016-0624-y.
[14] Zhu L, Xu QJ, Kou W, et a1. Outcome of free digital artery perforator flap transfer for reconstruction of fingertip defects[J]. Indian J Orthop, 2014, 48(6): 594-598. DOI: 10.4103/0019-5413.144228.