Da-Wei Zheng1, Zhang-Can Li2, Feng Sun2, Rong-Jian Shi2, Kui-Shui Shou2. 1. Department of Hand Surgery, Xuzhou Renci Hospital, Xuzhou, Jiangsu Province, People's Republic of China; Department of Hand Surgery, Wuxi Hand Surgery Hospital, Wuxi, Jiangsu Province, Peoples Republic of China. Electronic address: davyzheng93006@163.com. 2. Department of Hand Surgery, Xuzhou Renci Hospital, Xuzhou, Jiangsu Province, People's Republic of China; Department of Hand Surgery, Wuxi Hand Surgery Hospital, Wuxi, Jiangsu Province, Peoples Republic of China.
Abstract
PURPOSE: To retrospectively evaluate the effectiveness and safety of using a distal ulnar artery perforator (DUAP)-based bilobed free flap (BFF) for the repair of complex digital defects in the hand. METHODS: We retrospectively studied 15 patients who sustained traumatic digital defects with complicating tendon and phalanx exposure and were hospitalized for repair using a DUAP-based BFF. Main outcome measures included patients' self-assessed physical appearance, total active motion, and 2-point discrimination. RESULTS: The flaps survived and the wounds healed with primary intention in all patients except one who experienced partial flap necrosis of the distal margin and required treatment with a second skin graft. Patients were observed for a mean of 13 months. The physical appearance and texture of the repaired fingers were assessed as good with minimal scarring. Total active motion and 2-point discrimination were 113° to 255° (contralateral, 255° to 275°) and 6 to 11 mm (contralateral, 5 to 8 mm), respectively. CONCLUSIONS: Use of the DUAP-based BFF is a feasible, effective, and safe treatment alternative for repairing complex digital defects with favorable aesthetic and sensorimotor outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
PURPOSE: To retrospectively evaluate the effectiveness and safety of using a distal ulnar artery perforator (DUAP)-based bilobed free flap (BFF) for the repair of complex digital defects in the hand. METHODS: We retrospectively studied 15 patients who sustained traumatic digital defects with complicating tendon and phalanx exposure and were hospitalized for repair using a DUAP-based BFF. Main outcome measures included patients' self-assessed physical appearance, total active motion, and 2-point discrimination. RESULTS: The flaps survived and the wounds healed with primary intention in all patients except one who experienced partial flap necrosis of the distal margin and required treatment with a second skin graft. Patients were observed for a mean of 13 months. The physical appearance and texture of the repaired fingers were assessed as good with minimal scarring. Total active motion and 2-point discrimination were 113° to 255° (contralateral, 255° to 275°) and 6 to 11 mm (contralateral, 5 to 8 mm), respectively. CONCLUSIONS: Use of the DUAP-based BFF is a feasible, effective, and safe treatment alternative for repairing complex digital defects with favorable aesthetic and sensorimotor outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.