Nerve anastomosis thumb thumb distal ulnar dorsal flap of soft tissue defects.doc

 PAGE \* MERGEFORMAT 6 Nerve anastomosis thumb thumb distal ulnar dorsal flap of soft tissue defects [Keywords:] thumb flap repair of soft tissue defects Thumb distal phalanx associated with soft tissue defect over the exposed tendons and clinical practice can choose a variety of flap repair. Thumb-foot dorsal flap is the first in 1999 by the French Brunelli et al [1] reported. The flap is the thumb dorsal neurocutaneous flap, in recent years, for the cutaneous nerve nutrient vessel of the blood supply of the study in-depth so that in wound healing in the treatment of hot spots. November 2006 -2,008 years in February, our hospital thumb ulnar dorsal neurocutaneous vascular flap treatment of such injuries in 20 cases, satisfactory results are reported as follows. A clinical data 1.1 General Information The group of 20 patients, 13 males and 7 females, aged from 17 to 56 years, with an average 32.7 years of age. Cause of his injuries: machine twisting injury in 9 cases, 6 cases of knife cuts, crush injuries in 3 cases, blast injury in 2 cases. One fingertip radial defect in 5 cases, distal pulp defect in 6 cases, the tip of finger ulnar defect in 4 cases, refer to correct defects in front of three cases, two cases of nail bed defects. Flap in this group the largest area of 2.5 cm * 3.5 cm, the smallest of 1.0 cm * 2.0 cm. 1.2 surgical 1.2.1 flap flap pivot point for the thumb proximal phalanx distal phalanx neck close to the level of Office, the pedicle groove 2.3 cm distal from the A Division. The level of the axis for the first metacarpal bone away from the thumb interphalangeal joint dorsal midpoint and the midpoint of the metacarpophalangeal joints to connect the dorsal ulnar 1.0 cm away from the Department and the level of the interphalangeal joints to connect ulnar 0.7 cm at the connection points . Do not fall on the tiger’s mouth flap area. The wounds were designed to flap should drop, or tennis racket-shaped, with an area should be higher than by t