Clinical Research Of Greeter Thenar Palmar Reversed Island Flap In Reparing Of Thumb Soft Tissue Defect

Objective:Objective To explore the effect of greeter thenar palmar reversed island flap with neurovascular pedicle and minimal free flap in reparing of thumb soft tissue defectMethods:from 2001 to 2008,71 cases distal thumb sofe tissue defect was repared:Abdominal flap 12 cases The index finger dorsal island flap 16 cases, thumb at palmar side island flap15 cases,, greeter thenar palmar reversed island flapl3cases,the big toe skin flap 15 cases 13 cases was used to greeter thenar palmar reversed island flap male10 case, femal 3case, Aged 22 to 51 years old, mean age 32.4 years Injury due to Saw 4 cases, planer in 4 cases,3 cases of crush injury, cuts 2.6 cases of pulp defect; 5 with fingertip defect The flap was devised at the greater thenar with pedicle of thumb radialpalmar artery.The rotation point was proximal to the interphalangeal joint..The flap ranged from4.1×2.8cm to 2.2x 1.5cm connecting neurocutaneous and finger nerve for 10 cases.and summarized after ten days the results of 71 patients whose data were completely acquired,according to the shapes,sweating sensory and motor functions etc.71 patients, by operative time, blood loss and comprehensive sense to compareResults:71 patients with flaps all survived. Index finger dorsal flap mean operative time 38min, bleeding 20ml; thumb dorsal radial flap mean operative time was 45min, blood loss was 25ml; thumb radial thenar flap mean operative time was 42min, bleeding 29ml; abdominal flap average operative time 39min, bleeding 80ml; free toe pulp flap mean operative time was 300min, bleeding 165ml. thenar palmar reversed island flap operation time, blood loss compared with the other four kinds of methods were significantly different. Were followed up for 12 to 18 months, an average of 15 months. Subject to final review, the index finger the fine texture of dorsal skin flap rate of consolidated 62.5%; thumb dorsal radial flap of the superior rate of 80%; thumb radial thenar flap fine rate was 84.6%; abdominal flap 25% good; free toe flap of excellent and good rate was 86.7%, The shapes,sweating and sensory of the thumb pulp with greeter thenar palmar reversed island flap were excellent to Abdominal flap The index finger dorsal island flap, and similar to thumb at ulnar side island flap, greeter thenar palmar reversed island flap,the big toe skin flapConclusion:The greeter thenar palmar reversed island flap with neurovascular pedicle and minimal free flap in reparing of thumb soft tissue defect has advantages of simple performance and reliable blood supply and reconstruct its sensation.