Clinical Application Of Free Venous Flap With Long Tendon In Repairing The Dorsal Finger Wound With Tendon Defect

Objective: To explore the clinical effect of the use of the free vein flap with the tendon of the palmar long muscle to repair the dorsum of the finger with the tendon defect.Methods: From December 2010 to May 2017,a total of 12 cases of finger dorsum wounds with tendon defects were repaired by free flap with long palmar longus tendon flap.8 cases were male,4 female;the average age is 18~54 years old,33 years old;both dorsal skin defect with tendon defect,skin defect was 2.0cm ×2.5cm,the minimum is 0.8cm ×0.5cm,the tendon defect length is about 0.8cm~2.0cm,flap area was 2.5cm × 3.0cm,0.9cm × 0.6cm minimum.According to the shape and size of the skin defect and the length of the tendon defect,we designed a venous flap with palmar longus tendon to repair the compound tissue wound with tendon defect.Results: All 12 flaps survived,including 2 cases who had blisters within 3 days after operation,and had been successfully treated with anticoagulant therapy after dressing change,and 2 cases survived.All 12 patients were followed up for 3~18 months,with an average of 11 months.After operation,the flap was soft and elastic,1 cases had pigmentation at early stage,and the skin flap restored the protective feeling.The function of finger extension and flexion recovered well,the donor area healed well,and there was no obvious scar hyperplasia.Conclusion: The free flap of the long palmar longus tendon is used to repair the wound of the dorsum of the fingers with tendon defects.It is a composite tissue flap supplied by abnormal blood supply,which once repaired the tendon defect and covered the wound,and the donor site was less damaged.