Osteocutaneous Repair of Fingers Using Blood Supplied Grafts
The aim of the investigation is to develop new methods of osteocutaneous repair of fingers providing the stability of their osseous basis and the possibility of reinnervation when a donor defect is minimal.
Materials and Methods. The repair of the first and triphalangeal fingers using transplantation of osteocutaneous complexes of various structures on microvascular anastomoses and the displacement of radial osteocutaneous flaps on vascular pedicle have been performed in 32 patients with traumatic hand defects of mechanical (23), thermal (8) and gunshot (1) etiology. The most part of finger soft tissues have been repaired by means of temporal pedicle flap plasty.
Results. Acceptability of grafts and displaced tissue complexes was 93.74%. There was one case of complete necrosis and one case of partial necrosis of the implant (3.13%). All cellulocutaneous flaps were accepted. Primary stitches were put on all donor wounds which healed with primary adhesion and minimal defects. Biochemical parameters on intact and operated feet in various periods after the surgery did not differ significantly.
From 19 patients, whose long-term outcomes are known, excellent functional results are noted in 2 (10.53%) patients, good results — in 7 (36.84%) patients, satisfactory results — in 6 (31.58%) patients, and poor results — in 4 (21.05%) patients.
- Afanas’ev L.M. Khirurgicheskaya taktika v lechenii bol’nykh s otkrytymi sochetannymi povrezhdeniyami verkhnikh konechnostey i ikh posledstviyami. Avtoref. dis. … dokt. med. nauk [Surgical approach in treatment of patients with open concomitant injuries of upper extremities and their circumstances. Abstract of Dissertation for the degree of Doctor of Medical Science]. Novosibirsk; 1999.
- Petrov S.V., Aleksandrov N.M. Kombinirovannye metody vosstanovleniya luchevogo kraya kisti [Combined methods of restoration of radial edge of a hand]. Nizhny Novgorod; 1997; 16 p.
- El-Khatib Н.А., Hammouda А.Н. Reverse osseofasciocutaneous radial forearm flap for thumb reconstruction: а flap design and case series. J Hand Surg 2005 Nov; 30(6): 1298–1304.
- Aleksandrov N.M., Petrov S.V. Sposob formirovaniya sdvoennogo kozhno-zhirovogo loskuta [The way of formation of doubled cellulocutaneous flap]. Patent 2112448 RF, MPK A61 V 17/56. 1998.
- Azolov V.V. Rekonstruktivno-vosstanovitel’nye operatsii pri utrate pal’tsev kisti i nekotorye sotsial’no-ekonomicheskie aspekty etoy problem. Avtoref. dis. … dokt. med. nauk [Reconstructive and restorative surgeries in loss of fingers and some social and economic aspects of the problem. Abstract of Dissertation for the degree of Doctor of Medical Science]. Moscow; 1977.
- Petrov S.V., Aleksandrov N.M. Sposob plastiki loktevogo kraya kisti pri kul’tyakh 2–5 pyastnykh kostey [The technique of plasty of ulnar edge of a hand in stumps of 2–5 metacarpal]. Patent 2061425 RF, MPK A61 V 17/56. 1996.
- Aleksandrov N.M., Mitrofanov N.V. Sposob kombinirovannoy plastiki kul’ti pervogo pal’tsa kisti [The technique of a combined plasty of the first finger stump]. Patent 2210334 RF, MPK A61 V 17/56. 2003.
- Aleksandrov N.M. Sposob formirovaniya kozhno-kostnogo pal’tsa kisti iz luchevogo loskuta [The way of formation of osteocutaneous finger from radial flap]. Patent 2214173 RF, MPK A61 V 17/00, A61 V 17/56, A61 V 17/322. 2003.
- Lee K.S., Park J.W., Chung W.K. Thumb reconstruction with a wraparound free flap according to the level of amputation. J Hand Surg 2000 July; 25(4): 644–650.
