Article Sidebar

article details
Date Published: 29/04/2024
Online Published: 29/04/2024
Abstract Views: 144
Views article details: 55
DOI: https://doi.org/10.54804/yhthvb.2.2024.312
Issue
No. 2 (2024)
Section
Articles
How to Cite
Nguyen, M. D., Vo, T. T., & Nguyen, T. D. (2024). The results of reconstructing the defect of the distal part of the thumb with the dorsal pedicle flap of the index finger. Journal of Disaster Medicine and Burn Injuries, 2, 27-37. https://doi.org/10.54804/yhthvb.2.2024.312

The results of reconstructing the defect of the distal part of the thumb with the dorsal pedicle flap of the index finger

Nguyen Minh Duong1, Vo Thanh Toan2,, Nguyen Thien Duc1
1 Thong Nhat Hospital
2 School of Medicine- Vietnam National University Ho Cho Minh city

Main Article Content

Abstract

Objectives: To evaluate the results of reconstructive surgery of the soft tissue defect of the distal thumb with the first dorsal metacarpal artery (FDMA) flap at the Thong Nhat Hospital.
Subjects and methods: A prospective descriptive study of 15 patients, who had soft tissue defects with exposed thumb bone, who underwent microsurgery to the FDMA flap coverage at the Thong Nhat Hospital from May 2016 to May 2020.
Results: the proportion of males (66.7%) was higher than that of females (33.3%). The average age was 32 years old (from 18 to 54 years old). Causes of injury: 6 patients had labor accidents, 5 had traffic accidents, and 4 had living accidents. Flap size ranges from 2.5 - 3.5cm in length and 2 - 2.5cm in width. The average length of the flap pedicle is 7.0cm (from 6.0 cm to 7.5 cm). 6 patients with dorsal defect and 4 patients with volar defect. 5 patients have defects in both the dorsal surface and the volar surface of the thumb. All patients were satisfied with the surgical results. No patient had complete flap necrosis. There were 2 patients with partial necrosis of the flap that continued to be observed, then the necrosis broke out on its own and healed.
Conclusions: The soft tissue defect of the distal thumb with exposed bone can be reconstructed by FDMA flap with satisfactory functional results, few complications.

Article Details

Keywords

Soft tissue defect, first dorsal metacarpal artery flap, thumb

References

1. Pelzer Michael; Sauerbier Michael; Germann Günter; Tränkle Markus. Free “Kite” Flap: A New Flap for Reconstruction of Small Hand Defects. Journal of Reconstructive Microsurgery, 20(5), 367-372. doi:10.1055/s-2004-830000.
2. R Adani, R Busa, A Bathia, A Caroli. The "kite flap" for dorsal thumb reconstruction. Acta Chir Plast. 1995;37(3):63-6.
3. Xu Zhang; Yajie He; Xinzhong Shao; Yanchuang Li; Shumin Wen; Hongwei Zhu (2009). Second Dorsal Metacarpal Artery Flap From the Dorsum of the Middle Finger for Coverage of Volar Thumb Defect, 34(8), 0-1473. doi:10.1016/j.jhsa.2009.04.040.
4. Couceiro J, de Prado M, Menendez G, Manteiga Z. The First Dorsal Metacarpal Artery Flap Family: A Review. Surg J (N Y). 2018 Oct 29;4(4):e215-e219. doi: 10.1055/s-0038-1675369. PMID: 30377656; PMCID: PMC6205856.
5. Muyldermans T, Hierner R. First dorsal metacarpal artery flap for thumb reconstruction: a retrospective clinical study. Strategies Trauma Limb Reconstr. 2009 Apr;4(1):27-33. doi: 10.1007/s11751-009-0056-1. Epub 2009 Apr 2. PMID: 19340522; PMCID: PMC2666828.
6. Satish C, Nema S. First dorsal metacarpal artery islanded flap: A useful flap for reconstruction of thumb pulp defects. Indian J Plast Surg 2009;42:32-5.
7. El Khatib HA. Clinical experiences with the extended first dorsal metacarpal artery island flap for thumb reconstruction. J Hand Surg [Am] 1998;23:647-52.
8. Kola N. Thumb Reconstruction Using Foucher’s Flap. J Med Sci 2016;4:70-3.
9. Eski M, Nisanci M, Sengezer M. Correction of thumb deformities after burn: Versatility of first dorsal metacarpal artery flap. Burns 2007;33:65-71.
10. Ege A, Tuncay I, Ercetin O. Foucher’s first dorsal metacarpal artery flap for thumb reconstruction: evaluation of 21 cases. Isr Med Assoc J 2002;4:421-3.
11. Chang SC, Chen SL, Chen TM, Chuang CJ, Cheng TY, Wang HJ. Sensate first dorsal metacarpal artery flap for resurfacing extensive pulp defects of the thumb. Ann Plast Surg 2004;53:449-54.
12. Ahmad Mohammad AGGAG, Waleed Saber ABOEL-HASAN, Mohamed ABDEL-AAL. A Comparison of Outcomes of Reconstruction of Palmar versus Dorsal Defects of the Thumb Using a First Dorsal Metacarpal Artery Flap with a Cutaneous Bridge Segment. The Journal of Hand Surgery (Asian-Pacific Volume) Vol. 27, No. 02, pp. 313-319 (2022).
13. Al Lahham Salim, Ahmed Mohamed Badie, Aljassem Ghanem, Sada Ruba, Alyazji Zaki T. N., Thomas Jimmy. A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge. Plastic and Reconstructive Surgery, Global Open: February 2021, Volume 9, Issue 2, p e3434.