Digital artery bilobed flap for the treatment of skin degloving injury of thumb / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effects of digital artery bilobed flap for the treatment of skin degloving injury of thumb.</p><p><b>METHODS</b>From January 2007 to December 2012, 45 patients with skin degloving injury of thumb were treated with grafting of digital artery bilobed flap. There were 39 males and 6 females, ranging in age from 19 to 46 years, with an average of 32 years. The disease course ranged from 0.5 to 15 h. Eighteen patients suffered from defect of palmar skin above nail root and nail bed, 19 patients suffered from skin degloving injury of thumb phalangette, and 8 patients had whole skin degloving injury of thumb. The double lobe flaps were designed at the ulnar side of middle finger and the radial side of ring finger according to the defect of thumb skin. The arteria digitalis communis between the middle and ring fingers and its two branches of arteriae digitales propriae supplying the two fingers were used as a vessel pedicle. The flap with digitales proprii nervi was transposed and used to cover the exposed phalanx of thumb. Full thickness graft was used for the donor site. Observation of the appearance, texture, color and wear resistance of flap, appearance, color and depression of grafting area, skin feeling, and finger activities was conducted.</p><p><b>RESULTS</b>All the flaps and grafts were alive. Forty-three patients were followed up with an average duration of 25 months, and two patients lost follow-up. The color and texture of the flaps were similar to that of the contralateral thumb pulp. The average two point discrimination was 4.2 +/- 0.3 mm. The color of graft skin was slightly deeper than that of the surroundings skin.</p><p><b>CONCLUSION</b>Digital artery bilobed flap graft is an effective and ideal operation, which is of low risk and high success rates for skin degloving injury of thumb.</p>

Treatment of the windblow hand deformity / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the treatment of the windblow hand deformity.</p><p><b>METHODS</b>We treat 18 patients with operations step by step. First phase: to improve the thumb function; Second phase: shift the flexor digitorum superficialis of the middle and little finger to improve the ulnar drift of the digits; Third phase : to solve the flection deformity of the palm and digits.</p><p><b>RESULTS</b>We follow the patients for 6 - 72 months, only lost 3.11 of 15 patients have the thumb function recovered. 9 patients had their ulnar drift of the digits corrected, 2 patients partly corrected, 4 have relapse. 5 among the 15 patients were offered second operation, to have the ulnar arthrosis bursa contracted, using abduction splint, after rehabilitation 4 patients have the deformity corrected, 1 has partly corrected.</p><p><b>CONCLUSIONS</b>Operation step by step is better for the complex windblow hand deformity, solve one major problem each time,and systemic rehabilitation therapy is needed for satisfied curative effect.</p>