A complex soft tissue reconstruction of distal phalanges in children
- 作者: Alexandrov A.1, Goncharuk P.1, Idris L.2, Rybchenok V.1,3, Smirnov A.2
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隶属关系:
- Filatov Moscow Children’s Clinical Hospital
- N.I. Pirogov Russian National Research Medical University
- Research Institute of clinical surgery, Pirogov Russian National Research Medical University
- 期: 卷 11, 编号 1 (2021)
- 页面: 27-38
- 栏目: Original Study Articles
- URL: https://journals.rcsi.science/2219-4061/article/view/123508
- DOI: https://doi.org/10.17816/psaic701
- ID: 123508
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BACKGROUND: Injuries of distal phalanges are the most common type of hand trauma in children. The problem of coverage of soft tissue defects of distal phalanges remains. Many methods of coverage of distal phalanges defects have been developed. There is no generally accepted approach or an algorithm in treatment of adults and children with such type of trauma.
AIM: This study aimed to reveal the most universal method of coverage of distal phalanges defects in children using various reconstruction methods that are used at the Department of Reconstructive Microsurgery of Filatov State Children Hospital.
MATERIALS AND METHODS: From 2019 to 2020, 70 children with defects of distal phalanges were treated. The coverage of defects was performed by using a flap (n = 23), cross-finger flap (n = 5), V-Y advancement flap (n = 28), reverse-flow homodigital island flap (n = 11), and full-thickness skin graft (n = 3). Results of the defect coverage were evaluated by objective (difference between the lengths of the operated and contralateral phalanges, two-point discrimination test, presence/absence of stiffness in the distal interphalangeal joint) and subjective (definition of cold intolerance, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire) criteria.
RESULTS: The largest difference between the lengths of the operated and contralateral phalanges was obtained in V-Y plasty. The two-point discrimination sensitivity was the highest in V-Y plasty and a little less with island flap. Cold intolerance was the most common complication of homodigital island flap. Results of the DASH survey was the best in the homodigital island flap and full-thickness skin graft.
CONCLUSION: Based on the analysis of the experience of surgeries to close soft tissue defects of the nail phalanges, the best results were obtained with reverse-flow homodigital island, which is considered as the most versatile and reliable approach.
作者简介
Alexander Alexandrov
Filatov Moscow Children’s Clinical Hospital
Email: alexmicrosurg@mail.ru
ORCID iD: 0000-0002-6110-2380
SPIN 代码: 5229-0038
Head of the Department of Microsurgery
俄罗斯联邦, 15 Sadovaya-Kudrinskaya str., Moscow, 103001Pavel Goncharuk
Filatov Moscow Children’s Clinical Hospital
编辑信件的主要联系方式.
Email: gonelpav@rambler.ru
ORCID iD: 0000-0002-9560-037X
surgeon
俄罗斯联邦, 15 Sadovaya-Kudrinskaya str., Moscow, 103001Lamiya Idris
N.I. Pirogov Russian National Research Medical University
Email: idrislamiya@mail.ru
ORCID iD: 0000-0002-4902-7939
resident pediatric surgeon
俄罗斯联邦, 15 Sadovaya-Kudrinskaya str., Moscow, 103001Vsevolod Rybchenok
Filatov Moscow Children’s Clinical Hospital; Research Institute of clinical surgery, Pirogov Russian National Research Medical University
Email: sevasurgeon@gmail.com
ORCID iD: 0000-0001-9635-891X
SPIN 代码: 2545-8675
Dr. Sci. (Med.)
俄罗斯联邦, 15 Sadovaya-Kudrinskaya str., Moscow, 103001Alexander Smirnov
N.I. Pirogov Russian National Research Medical University
Email: smirnov_aan@bk.ru
ORCID iD: 0000-0002-7274-8291
postgraduate student
俄罗斯联邦, 15 Sadovaya-Kudrinskaya str., Moscow, 103001参考
- Bajtinger VF, Golubev IO. Essays of clinical anatomy of the hand 2012. Tomsk: Deltaplan; 2012. P. 104–105. (In Russ.)
- Borrelli MR, Landin ML, Agha R, Greig A. Composite grafts for fingertip amputations: A systematic review protocol. Int J Surg Protoc. 2019;(16):1–4. doi: 10.1016/j.isjp.2019.05.001
- Yorlets RR, Busa K, Eberlin KR, et al. Fingertip Injuries in Children: Epidemiology, Financial Burden, and Implications for Prevention. Hand (NY). 2017;12(4):342–347. doi: 10.1177/1558944716670139
- Doraiswamy NV, Baig H. Isolated finger injuries in children — incidence and aetiology. Injury. 2000;31(8):571–573. doi: 10.1016/s0020-1383(00)00052-8
- Fetter-Zarzeka A, Joseph MM. Hand and fingertip injuries in children. Pediatr Emerg Care. 2002;18(5):341–345. doi: 10.1097/00006565-200210000-00003
- Ljungberg E, Rosberg HE, Dahlin LB. Hand injuries in young children. J Hand Surg Br. 2003;28(4):376–380. doi: 10.1016/s0266-7681(03)00101-3
- Boudard J, Loisel F, El Rifaï S, et al. Fingertip amputations treated with occlusive dressings. Hand Surg Rehabil. 2019;38(4):257–261. doi: 10.1016/j.hansur.2019.06.002
- Germann G, Rudolf KD, Levin SL, Hrabowski M. Fingertip and Thumb Tip Wounds: Changing Algorithms for Sensation, Aesthetics, and Function. J Hand Surg Am. 2017;42(4):274–284. doi: 10.1016/j.jhsa.2017.01.022
- Lou X, Zhu H, Xue H, et al. One-stage wound healing of fingertip injuries induced by treatment of artificial dermis. Handchir Mikrochir Plast Chir. 2018;50(4):269–275. doi: 10.1055/s-0044-102304
- Kawaiah A, Thakur M, Garg S, et al. Fingertip Injuries and Amputations: A Review of the Literature. Cureus. 2020;12(5):e8291. doi: 10.7759/cureus.8291
- Mahdi Abood H. A comparative study of the supraperiosteal and the subperiosteal dissection in the V-Y advancement (atasoy) flap for the management of fingertip injury. Basrah J. Surg. 2007;13(1):1–11 doi: 10.33762/bsurg.2007.56239
- Jackson EA. The V-Y plasty in the treatment of fingertip amputations. Am Fam Physician. 2001;64(3):455–458.
- Lim JX, Chung KC. VY Advancement, Thenar Flap, and Cross-finger Flaps. Hand Clin. 2020;36(1):19–32. doi: 10.1016/j.hcl.2019.08.003
- Schenck RR, Cheema TA. Hypothenar skin grafts for fingertip reconstruction. J Hand Surg Am. 1984;9(5):750–753. doi: 10.1016/s0363-5023(84)80029-5
- Acar MA, Güzel Y, Güleç A, et al. Reconstruction of multiple fingertip injuries with reverse flow homodigital flap. Injury. 2014;45(10):1569–1573. doi: 10.1016/j.injury.2014.06.009.
- Han SK, Lee BI, Kim WK. The reverse digital artery island flap: clinical experience in 120 fingers. Plast Reconstr Surg. 1998;101(4):1006–1011. doi: 10.1097/00006534-199804040-00018
- Adani R, Busa R, Pancaldi G, Caroli A. Reverse neurovascular homodigital island flap. Ann Plast Surg. 1995;35(1):77–82. doi: 10.1097/00000637-199507000-00015
- Hudak P, Amadio PC, Bombardier C, et al. Development of an Upper Extremity Outcome Measure: The DASH (Disabilities of the Arm, Shoulder, and Hand). Am J Ind Med. 1996;29(6):602–608.
- Weir Y. Fingertip injuries in children: a review of the literature. Emerg Nurse. 2018;26(3):17–20. doi: 10.7748/en.2018.e1795
- Pannier S, Dana C, Journé A, et al. [Fingertip injuries in children]. Chir Main. 2013;32(1):S39–45. doi: 10.1016/j.main.2013.02.020
- Sullivan MA, Cogan CJ, Adkinson JM. Pediatric Hand Injuries. Plast Surg Nurs. 2016;36(3):114–120. doi: 10.1097/PSN.0000000000000145
- Venkatesh A, Khajuria A, Greig A. Management of Pediatric Distal Fingertip Injuries: A Systematic Literature Review. Plast Reconstr Surg Glob Open. 2020;8(1):e2595. doi: 10.1097/GOX.0000000000002595
- Miller AJ, Rivlin M, Kirkpatrick W, et al. Fingertip Amputation Treatment: A Survey Study. Am J Orthop (Belle Mead NJ). 2015;44(9):E331–339.
- Petrushin AL. Traumatic amputations of hand segments, analysis of treatment on different stages in contryside. Kazan Medical Journal. 2013;94(3):327–334. (In Russ.)
- Khodzhabaghyan ZS, Pshenisnov KP, Abraamyan DO. Surgical management of distal phalangeal injuries of fingers (review). Issues of Reconstructive and Plastic Surgery. 2016;19(1):74–92. doi: 10.17223/1814147/56/11
- Fijan A, Hashemi A, Namazi H. A novel use of amniotic membrane for fingertip injuries. J Wound Care. 2014;23(5):255–258. doi: 10.12968/jowc.2014.23.5.255
- Krauss EM, Lalonde DH. Secondary healing of fingertip amputations: a review. Hand (NY). 2014;9(3):282–288. doi: 10.1007/s11552-014-9663-5
- Allen MJ. Conservative management of finger tip injuries in adults. Hand. 1980;12(3):257–265. doi: 10.1016/s0072-968x(80)80049-0
- Ozer K, Kramer W, Gillani S, et al. Replantation versus revision of amputated fingers in patients air-transported to a level 1 trauma center. J Hand Surg Am. 2010;35(6):936–940. doi: 10.1016/j.jhsa.2010.02.031
- Erken HY, Takka S, Akmaz I. Artery-only fingertip replantations using a controlled nailbed bleeding protocol. J Hand Surg Am. 2013;38(11):2173–2179. doi: 10.1016/j.jhsa.2013.08.110
- Venkatramani H, Sabapathy SR. Fingertip replantation: Technical considerations and outcome analysis of 24 consecutive fingertip replantations. Indian J Plast Surg. 2011;44(2):237–245. doi: 10.4103/0970-0358.85345
- Atasoy E, Ioakimidis E, Kasdan ML, et al. Reconstruction of the amputated finger tip with a triangular volar flap. A new surgical procedure. J Bone Joint Surg Am. 1970;52(5):921–926.
- Regmi S, Gu JX, Zhang NC, Liu HJ. A Systematic Review of Outcomes and Complications of Primary Fingertip Reconstruction Using Reverse-Flow Homodigital Island Flaps. Aesthetic Plast Surg. 2016;40(2):277–283. doi: 10.1007/s00266-016-0624-y
- Acar MA, Güzel Y, Güleç A, et al. Reconstruction of multiple fingertip injuries with reverse flow homodigital flap. Injury. 2014;45(10):1569–1573. doi: 10.1016/j.injury.2014.06.009