Dorsal Branch of Digital Artery with Dorsal Branch of Proper Digital Nerve in the Treatment of Scar Flexion Contractures of Fingers
Objective To explore the clinical efficacy of the dorsal branch of the digital artery with the dorsal branch of the proper digital nerve in the treatment of scar flexion contractures of fingers.Methods A retrospective analysis was performed on the clinical data of 12 patients(12 fingers)with finger scar contracture and flexion deformity admitted to our hospital from April 2016 to May 2020.There were 7 males and 5 females,aged from 12 to 34 years old(mean 20.4 years old).There were 7 cases of burn,4 cases of crush and 1 case of strangulation.There were 5 index fingers,3 middle fingers,3 ring fingers,and 1 little finger.The degree of flexion deformity in all patients was classified according to McCauley's classification of interphalangeal flexion deformity,including 10 cases of type Ⅲ and 2 cases of type Ⅳ.The skin defect was 2.8 cm×2.5 cm-3.9 cm×3.0 cm after the correction of flexion deformity by completely loosening the finger scar contracture during the operation.The skin defect was repaired by the dorsal branch of the digital artery with the dorsal branch of the proper digital nerve,and the donor area was repaired by medium-thickness skin graft.The skin flap texture,appearance,feeling and hand activity recovery were observed by regular outpatient follow-up after operation.The finger function was evaluated according to the trial criteria of the upper limb function evaluation of the Chinese Medical Association Hand Surgery Society.Results The operation was successful in 12 cases,and all the skin grafts in the skin flap donor area survived.In 1 case,the skin flap showed bruising and a little necrosis of the skin margin,and the healing was delayed.The average follow-up time was 14.6 months(range:13-17 months).The flap had good appearance,soft texture and no bloated.The two-point resolution of the flap was 4-8 mm,with an average of 5.7 mm.There were 3 cases of ectopic sensory localization.According to the trial criteria of the upper limb function evaluation of the Chinese Medical Association Hand Surgery Society,4 cases were excellent,7 cases were good,and 1 case was fair.Excellent and good rate was 91.7％.The flexion deformity of the affected finger was corrected,the active extension and flexion function was improved,and no scar contracture and flexion deformity occurred again.Conclusion The application of the dorsal branch of the digital artery with the dorsal branch of the proper digital nerve to repair the soft tissue defect after the release of the scar,carrying the nerve can reconstruct the sensory loss of the affected finger,the operation is simple,safe and reliable,and the function and appearance of the finger are significantly improved after surgery.It is the effective surgical method for the treatment of finger scar contracture flexion deformity.
FlagFingerScar contractureFlexion deformityProper digital nervesOrthopedics
NETL
NSTL
万方数据
