Objective: To investigate the effectiveness of part long thumb extensor tendon dorsal ulnar artery chimeric flap for repair of Doyle type Ⅲ mallet finger of thumb.
Methods: Between June 2013 and April 2015, 9 cases of Doyle type Ⅲ mallet finger of thumb were treated, which were caused by planer injury. There were 6 males and 3 females, aged from 15 to 65 years (mean, 36 years). The time from injury to operation was 3-8 hours (mean, 5 hours). All cases had interphalangeal joint dorsal skin and soft tissue defects of the thumb; the skin defects ranged from 2.0 cm×1.5 cm to 2.3 cm×2.3 cm; the extensor tendon defect ranged from 0.5 to 1.5 cm in length (mean, 1.0 cm). The part long thumb extensor tendon dorsal ulnar artery chimeric flap of 3.0 cm×2.5 cm to 3.5 cm×3.0 cm in size was used to reconstruct extensor tendon and wound. The donor site was repaired with nasopharyngeal fossa perforating branches pedicled V-Y relay flap.
Results: All flaps survived completely and incisions healed by first intention. All patients were followed up 4-12 months (mean, 6 months). The flaps had good color, texture, and contour. At 6 months after operation, the two-point discrimination of chimeric flap was 10-12 mm (mean, 11 mm), and two-point discrimination of relay flap was 12-14 mm (mean, 13 mm). The interphalangeal joint flexion of thumb was 0-40°, and the thumb opposition function was normal.
Conclusions: Part long thumb extensor tendon dorsal ulnar artery chimeric flap can repair the Doyle type Ⅲ mallet finger of thumb, which has no injury to the artery and nerve. At the same time the relay flap can achieve linear healing, so good appearance and function of the thumb can be obtained.
目的: 探讨带部分拇长伸肌腱的尺侧指背动脉嵌合皮瓣修复拇指Doyle Ⅲ型锤状指的疗效。.
方法: 2013年6月-2015年4月，收治9例（9指）电刨伤所致的拇指Doyle Ⅲ型锤状指患者。男6例，女3例；年龄15～65岁，平均36岁。受伤至手术时间3～8 h，平均5 h。均为拇指指间关节背侧皮肤软组织缺损，缺损范围为2.0 cm×1.5 cm～2.3 cm×2.3 cm；均伴拇指背侧伸肌腱缺损，缺损长度0.5～1.5 cm，平均1.0 cm。采用带部分拇长伸肌腱的尺侧指背动脉嵌合皮瓣（3.0 cm×2.5 cm～3.5 cm×3.0 cm）修复创面、重建伸肌腱止点，供区创面以鼻咽窝穿支为蒂的V-Y接力皮瓣修复。.
结果: 术后供、受区皮瓣均顺利成活，创面Ⅰ期愈合。患者均获随访，随访时间4～12个月，平均6个月。皮瓣质地柔软，外观良好、蒂部无臃肿，颜色与周围皮肤接近。术后6个月，7例嵌合皮瓣两点辨别觉为10～12 mm，平均11 mm；接力皮瓣两点辨别觉为12～14 mm，平均13 mm。拇指指间关节屈伸活动度为0～40°，对指、对掌功能正常。.
结论: 采用带部分拇长伸肌腱的尺侧指背动脉嵌合皮瓣修复拇指Doyle Ⅲ型锤状指不损伤指动脉和指神经，同时供区可采用接力皮瓣修复，达到线状愈合，获得较好拇指外观及功能。.
Keywords: Chimeric flap; Doyle type Ⅲ mallet finger; Tendon; Thumb; Wound repair.