| ABSTRACT Abstract Objective：to explore the surgical methods and effects of three different types of mini skin flap transplantation for repairing finger soft tissue or bone defect. Methods: 33 patients were choose from December 2014 to October 2016(male: 24cases, female: 9 cases; age: from 21 to 52 years old, average age: 36.42±5.70), Soft tissue defect area: 1.3cm x 1.8cm ~ 2.3cm x 4.2cm. According to the damage degree, nature and the patients options, 15 finger of 15 cases were adopted the methods of retrograde dorsal metacarpal artery perforators fascia flap, 10 fingers of 9 cases were adopted the method of the free foot artery descending branch wrist skin flap, 9 fingers of 9 cases were adopted the method of the free second toe details phalanges compound flap.The surgical was evaluated by the survival rate and complications postoperative and finger function which was assessed by Dargan functional criteria at the last follow up. Results: All flaps were survival, both donor site and the recipient site were not deep infected including. In one case, the distal epidermis of the donor site was necrotic and healed after treatment.Follow-up period was 6~16 months, with an average (8.34 ±1.28) months. Two points of finger recognition were restored between 8 and 12mm, with an average of (8.84 ± 0.43) mm, and the appearance, texture and sensory functions of the skin flap were well restored. No obvious complications were observed in the donor site. Dargan function evaluation of finger joints: excellent (18 cases), good(14 cases) and medium(1 case). Conclusion: Three kinds of mini skin flap have a good effections in repairing soft tissue of finger or bone defect. Reverse dorsal metacarpal artery perforator fascia flap need not anastomosing blood vessels and has advantages of safe, simple and high survival rate. Descending branch of superior cutaneous branch of free ulnar artery can cut multiple other perforator flaps simultaneously,and the scar is small and hidden.Dissociated second toe combined metatarsal phalangeal flap can repair the shape and function of fingers to the maximum extent and provide hidden area. |
