Replanting the complex amputated thumb with the pedicled flap from the rasceta area

Abstract

Objective To explore the operative method and effect of replantation of complex severed thumb with the pedicled flap from the rasceta area. Methods From March, 2015 to March, 2017, 12 cases of complicated thumb injury were treated by retrograde transfer flap pedicled with the superficial palmar branch of the radial artery. All digital arteries defective with soft tissue defect, the area was 1.5 cm×3.0 cm to 5.5 cm ×7.0 cm. The wound of the wrist donor site was sutured directly. Postoperative followed-up was performed to review if the flap survival. Results There was 1 case of venous reflux disorder. After removal of some sutures, the symptoms were relieved. All other fingers survived successfully, and the flap survived completely. The donor site incision healed at I stage. The followed-up period was 12-18 (average, 13.5) months. The appearance of the thumb and flap was satisfactory, and the scar in the donor site was not obvious. The thumb function was evaluated according to the evaluation standard of thumb and finger reconstruction function of the Chinese society of medical surgery. Eight cases were excellent, 3 cases were good, and 1 case was medium. Conclusion The pedicled flap from the rasceta area has the advantages of simple operation and reliable blood supply. It can reconstruct the defect vessels and repair the wound at the same time. It is a new method for replantation of complicated severed thumb. Key words: Wrist transverse flap; Severed finger; Replantation; Microsurgical technique