Efficacy Analysis On Reconstruction Of Complete Degloving Injuries Of Thumb And Finger In 55 Cases

Objective To compare and assess the effects of the two treatments of repairing degloving injuries of thumb and finger.Methods From July 2003 to November 2013, 55 patients with thumb and finger degloving injuries were treated in our hospital. According to different therapeutic methods, the patients were divided into two groups: the group of second toe wrap-around flap and the group of combined flaps. 51 fingers were repaired with second toe wrap-around flap in 40 cases. 5 thumbs and 10 fingers were repaired with combined flaps in 15 cases. The standard functional evaluation issued by Hand Surgery Association of Chinese Medical Association, Michigan Hand outcome Questionnaire(MHQ)and Maryland foot rating score, were used to evaluate overall outcomes of the repaired hands and the donor sites after operation.Results Three evaluation methods were used to evaluate the two groups respectively., the functional results assessed by the standard functional evaluation issued by Hand Surgery Association of Chinese Medical Association in the second toe wrap-around flap were excellent in 23 cases,and good in 17 ones and the combined flaps were excellent in 15 cases, the excellent and good rate is 100 percent. The functional results assessed by the MHQ score in the second toe wrap-around flap, averaged 73.08 points and in the combined flaps is 84.33.The donor site results of the fingers repaired with second toe wrap-around flap assessed by Maryland foot rating score were excellent in 5 cases,good in 33 ones and fair in 2 cases, the excellent and good rate is 95 percent. In the fingers and thumbs repaired with combined flaps,the donor site results assessed by Maryland foot rating score were excellent in 13 cases,and good in 2 cases,the excellent and good rate is 100 percent.Conclusion The two methods of repairing degloving injuries of thumb and finger can achieve satisfactory results. The patient whose finger was repaired with combined flaps is more satisfied with the clinical effects, and the morbidity of the donor site is lower.