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Arterial or venous free flaps for volar tissue defects of the proximal interphalangeal joint: A comparison of surgical outcomes

Archives of Plastic Surgery 2020년 47권 5호 p.451 ~ 459
최민석, 노시영, 고성훈, 김진수, 이동철, 이경진, 홍민기,
소속 상세정보
최민석 ( Choi Min-Suk ) - Gwangmyeong Sungae Hospital Department of Plastic and Reconstructive Surgery
노시영 ( Roh Si-Young ) - Gwangmyeong Sungae Hospital Department of Plastic and Reconstructive Surgery
고성훈 ( Koh Sung-Hoon ) - Gwangmyeong Sungae Hospital Department of Plastic and Reconstructive Surgery
김진수 ( Kim Jin-Soo ) - Gwangmyeong Sungae Hospital Department of Plastic and Reconstructive Surgery
이동철 ( Lee Dong-Chul ) - Gwangmyeong Sungae Hospital Department of Plastic and Reconstructive Surgery
이경진 ( Lee Kyung-Jin ) - Gwangmyeong Sungae Hospital Department of Plastic and Reconstructive Surgery
홍민기 ( Hong Min-Ki ) - Gwangmyeong Sungae Hospital Department of Plastic and Reconstructive Surgery

Abstract


Background: For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint.

Methods: This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects >6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients’ age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups.

Results: Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P=0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant.

Conclusions: The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.

키워드

Free tissue transfer flaps; Interphalangeal joint of finger; Reconstructive surgical procedure

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