A COMPARATIVE-STUDY OF THE HETERODIGITAL NEUROVASCULAR ISLAND FLAP IN THUMB RECONSTRUCTION, WITH AND WITHOUT NERVE CONNECTION

被引：39

作者：

ADANI, R

SQUARZINA, PB

CASTAGNETTI, C

LAGANA, A

PANCALDI, G

CAROLI, A

机构：

[1] Hand Surgery Unit, Department of Orthopaedics, University of Modena

来源：

JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME | 1994年 / 19B卷 / 05期

关键词：

D O I：

10.1016/0266-7681(94)90113-9

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

41 heterodigital neurovascular island flaps were used to cover defects of the tactile pad of the thumb in 17 gears. With an average follow-up of 75.5 months, 30 patients were review ed. 17 were treated by the original Littler technique and 13 were treated with the same flap reconstruction but with division of the digital nerve innervating the flap and re-anastomosis of this nerve to the proximal nerve end of the ulnar digital nerve of the thumb. Good aesthetic and functional results were achieved in both groups. Sensory acuity did not appear to decrease with time. The nerve reconnection technique solves the ''double sensibility'' phenomenon (present in 41.1% of our cases treated by the original technique), but two-point discrimination is less than that achieved ba the Littler technique. Most complaints were related to the donor site such as hypertrophic scarring or scar contracture and cold intolerance, but these did not cause any real functional impairment.

引用

页码：552 / 559

页数：8

共 18 条

[1]

Adani, Pancaldi, Castagnetti, Zanasi, Squarzina, Neurovascular island flap by the disconnecting-reconnecting technique, Journal of Hand Surgery, 15 B, 1, pp. 62-65, (1990)

[2]

De Coninck, Transplantation hétéro-digitale avec réinnervation locale, Acta Orthopaedica Belgica, 41, 2, pp. 170-176, (1975)

[3]

Duparc, Roux, Restauration de la sensibilité au niveau de la main par transfert d'un transplant cutané hétéro-digital muni de son pédicule vasculo-nerveux: Etude critique des resultats, Annales de Chirurgie, 27, 5, pp. 497-502, (1973)

[4]

Foucher, Braun, Merle, Michon, La technique du “débranchement-rebranchement” due lambeau en ilot pédiculé, Annales de Chirurgie, 35, 4, pp. 301-303, (1981)

[5]

Henderson, Reid, Long-term follow-up of neurovascular island flaps, The Hand, 12, 2, pp. 113-122, (1980)

[6]

Krag, Rasmussen, The neurovascular island flap for defective sensibility of the thumb, Journal of Bone and Joint Surgery, 57 B, 4, pp. 495-499, (1975)

[7]

Littler, Neurovascular pedicle transfer of tissue in reconstructive surgery of the hand, Journal of Bone and Joint Surgery, 38 A, 4, (1956)

[8]

Luppino, Fiocchi, Balli, Ligabue, I lembi ad isola neurovascolare nella ricostruzione in urgenza della seconda falange del pollice, Giornale Italiano di Ortopedia e Traumatologia, 6, 1, pp. 67-76, (1980)

[9]

Markley, The preservation of close two-point discrimination in the interdigital transfer of neurovascular island flaps, Plastic and Reconstructive Surgery, 59, 6, pp. 812-816, (1977)

[10]

Merle, A critical study of thumb reconstruction by second toe transfer, Annals of Hand Surgery, 10, 6, pp. 517-522, (1991)

← 1 2 →