Application of V-Y advancement flap of the extensor pollicis longus tendon for repair of open mallet finger deformity
Objective To investigate the clinical efficacy of V-Y advancement flaps of the extensor pollicis longus tendon for repair of open mallet finger deformity with dorsal skin defects.Methods From April 2019 to April 2022,9 patients with mallet finger accompanied by a small composite tissue defect on the dorsal side of the thumb were treated.The defect was located on the dorsal side of the interphalangeal joint of the thumb,with a skin defect area of 0.5 cm × 0.5 cm to 1.5 cm × 1.5 cm,with a tendon defect length of 0.5 to 1.0 cm,the extensor tendon was repaired using the V-Y advancement flaps of the extensor pollicis longus tendon to cover the wound,and internal fixation with Kirschner wires was performed for 4 weeks.The texture,appearance,motor and sensory function recovery of the flap after surgery were followed up and observed,and the two-point discrimination of the flap,sensory recovery,and thumb flexion and extension activity were measured.Results All 9 flaps survived after surgery,and the follow-up time was 6 to 14 months,with an average of 10 months.After the flap repair,the appearance of the fingers was satisfactory,with good appearance,soft texture,and no contractures or concave scars.According to the trial criteria for evaluating upper limb function issued by Hand Surgery Society of the Chinese Medical Association,the hand function was evaluated as excellent in 6 cases and good in 3 cases.The two-point discrimination was 6 to 9 mm,with an average of 8.0 mm,and the sensation returns to S3.Conclusion Application of V-Y advancement flaps of the extensor pollicis longus tendon for repair of mallet finger accompanied by a small composite tissue defect on the dorsal side of the thumb is a good method for repairing such injuries,with simple surgery and minimal damage to the donor area.
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