Analysis of related influencing factors of limited finger mobility after reverse digital artery island flap repair of finger pulp defect
Objective To observe the incidence of restricted finger movement after the repair of finger pulp defects with reverse digital artery island flap and analyze its related influencing factors.Methods A retrospective analysis was conducted on the data of 107 patients(114 fingers)who underwent reverse digital artery island flap reconstruction of the fingertips in our hospital from January 2021 to January 2023.Twelve factors,including gender,age,finger type,cause of injury,design of pedicle incision,location of fingertip defect,flap area,shape and position of skin graft in the donor area,timing of scar laser treatment,timing and cycle of rehabilitation treatment,were analyzed.The relevant factors that affect postoperative finger mobility limitation were analyzed.Results All the 107 patients received functional follow-up from 6 months to 1 year after surgery,of which 40 fingers experienced postoperative mobility restriction,with an incidence rate of 35.1％.The results of univariate logistic regression analysis showed that postoperative finger mobility restriction was not related to the patient's gender,age,cause of injury,defect location(P＞0.05),but was related to the pedicle incision(P=0.030),flap area(P＜0.001),graft shape(P=0.008),graft location(P=0.044),laser treatment(P＜0.001),rehabilitation treatment timing(P=0.003),and rehabilitation treatment cycle(P=0.001).Multivariate logistic regression analysis found that the size of the skin flap was an independent risk factor for postoperative limited finger mobility(OR=3.045;95％Cl:1.578 to 5.875;P=0.001),which was not conducive to the recovery of finger mobility function.The early postoperative laser therapy(OR=0.017;95％Cl:0.003 to 0.102;P＜0.001)and early rehabilitation therapy(OR=0.139;95％Cl:0.026 to 0.754;P=0.022)are independent protective factors affecting postoperative finger mobility limitation.Conclusion The early scar laser and rehabilitation therapy can significantly reduce the incidence of postoperative restricted finger movement in patients undergoing digital artery retrograde island flap reconstruction of the digital pulp.The larger skin flap area is an independent risk factor for postoperative restricted mobility of the affected finger.In clinical practice,other surgical methods can be considered for repairing defects in such patients to reduce the incidence of postoperative restricted mobility.
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