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Comparison Of The Clinical Effects Of The Second Toe Tibial Flap With The Intrinsic Nerve Or The Dorsal Nerve To Repair The Finger Pulp Defect

Posted on:2021-02-10Degree:MasterType:Thesis
Country:ChinaCandidate:X S WangFull Text:PDF
GTID:2404330605955397Subject:Bone surgery
Abstract/Summary:PDF Full Text Request
Objective:In order to guide clinical practice,a comparative study was made on the sensory recovery of the recipient flap and the donor toe pulp after the repair of the defect of finger pulp by tibial flap of the second toe with the intrinsic nerve or the dorsal nerve.Methods:From December 2015 to December 2017,40 patients with finger pulp defect of 40 fingers treated by second toe tibial flap were selected.According to the different nerves carried by the flap,the cases of repairing the defect of the finger pulp with the flap of the intrinsic nerve of the toe were defined as the toe base group(20 cases with 20 fingers),and the cases of repairing the finger pulp with the flap of the dorsal nerve of the toe were defined as the toe back group(20 cases with 20 fingers).At the 20-month follow-up,the flap function evaluation,the flap scar evaluation,the total activity of the repaired finger,the two-point discrimination of recipient area flap,and the two-point discrimination of donor area toe pulp were used to evaluate the postoperative effects of the two groups.SPSS 23.0 statistical software was used to deal with the data of the two groups.Results:The skin flaps and skin grafts of all the two groups survived,all patients had normal gait,and the donor site of the leg healed in one stage.In terms of the flap function evaluation,the score of toe base group was 88.75 ± 7.93 and the score of toe back group was 91.25 ± 5.10.There was no significant difference between the two groups(P>0.05).In terms of the flap scar evaluation,the score of toe base group was 3.85±1.09 and toe back group was 3.90±1.02.There was no significant difference between the two groups(P>0.05).In terms of the movement function of the repaired finger,the total movement degree of the joint in the toe base group was 245.50±18.350 and the total movement degree of the joint in the toe back group was 251.25±14.59°.There was no significant difference between the two groups(P>0.05).In terms of the sensory recovery of the flap in the recipient area,the two-point discrimination in the toe base group was 9.35±1.66 mm and the two-point discrimination in the toe back group was 7.10±1.25 mm.The difference between the two groups was statistically significant(P<0.05).On the other hand,the recovery of sensation in the donor area toe pulp was 11.65±2.11 mm in the toe base group and the recovery of sensation in the donor area toe pulp was 7.95±1.15 in the toe back group.The difference between the two groups was statistically significant(P<0.05).The results showed that the two groups had good postoperative effects,and the sensory recovery of the recipient area flap and the donor area of the toe pulp were better than that of the toe base groupConclusion:The application of the tibial flap of the second toe has the advantages of high survival rate,good appearance,good texture,satisfactory sensory recovery and less damage to the donor area.Using the second tibial flap of the second toe to repair the defect of finger pulp,which can keep the intrinsic nerve of the toe and anastomose the dorsal nerve of the toe,can not only improve the sensory recovery of the flap in the recipient area,but also reduce the sensory damage of the donor area toe pulp,which is a better way to repair the defect of finger pulp.
Keywords/Search Tags:Finger injury, Free flap, Intrinsic nerve, Dorsal nerve, Transplantation
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