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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Yang Xi,Liu Wuhua,Duan Jiazhang,et al.Efficacy of free lateral arm tissue flap in repairing complex finger wounds[J].Chin J Burns Wounds,2025,41(12):1-8.DOI: 10.3760/cma.j.cn501225-20240927-00359.
Citation: Yang Xi,Liu Wuhua,Duan Jiazhang,et al.Efficacy of free lateral arm tissue flap in repairing complex finger wounds[J].Chin J Burns Wounds,2025,41(12):1-8.DOI: 10.3760/cma.j.cn501225-20240927-00359.
shu

Efficacy of free lateral arm tissue flap in repairing complex finger wounds

doi: 10.3760/cma.j.cn501225-20240927-00359
  • 1.

    Department of Orthopedics, the 920th Hospital of Joint Logistic Support Force of PLA, Kunming 650032, China

  • 2.

    Department of Hand and Foot Surgery, the Second People's Hospital of Yunnan Province, Kunming 650021, China

  • 3.

    Department of Traumatic Orthopedics, Pingdingshan Zhanhe Orthopedics Hospital, Pingdingshan 462500, China

Funds:

Clinical Center Construction Project of the Science and Technology Plan of Department of Science and Technology of Yunnan Province 202102AA310068

Science and Technology Talent and Platform Program Project under the Science and Technology Plan of Department of Science and Technology of Yunnan Province 202405AD350024

General Program of In-hospital Science and Technology Plan of the 920th Hospital of Joint Logistic Support Force of PLA 2023YGY15

More Information
  • Corresponding author: He Xiaoqing, Email: 6292753@qq.com
  • Received Date: 2024-09-27
    Available Online: 2025-11-27
    Abstract
  •   Objective  To explore the efficacy of free lateral arm flap in repairing complex finger wounds.  Methods  This study was a retrospective observational study. From January 2020 to December 2023, 8 patients with complex finger wounds who met the inclusion criteria were admitted to the 920th Hospital of Joint Logistic Support Force of PLA, including 5 males and 3 females, aged 24 to 56 years. There were 4 cases with multi-finger skin defects; there were 4 cases with single-finger skin combined with bone defects, 3 of whom were complicated with extensor tendon defects. The size of skin defects was 2.5 cm×2.0 cm to 8.0 cm×3.5 cm, and the size of bone defects was 1.5 cm×1.0 cm×1.0 cm to 2.0 cm×1.5 cm×1.0 cm. Five cases were repaired by free lateral arm tissue flap transplantation in the same period of emergency debridement; the remaining 3 patients underwent extended debridement in stage Ⅰ and free lateral arm tissue flap transplantation for repair in stage Ⅱ. Four patients each underwent resection of lobulated flaps and chimeric osteocutaneous flaps, including 4 cases carrying the posterior arm cutaneous nerve and three cases had their extensor tendons being reconstructed with the triceps brachii aponeurosis. The size of skin flaps was 3.0 cm×2.5 cm to 9.0 cm×4.0 cm, and the size of bone flap was consistent with the size of the bone defect. The donor site wounds of skin flaps and bone flaps were closed with interrupted sutures. Postoperatively, the survival status of the tissue flaps was observed, and the pedicle division status of the lobulated flaps was recorded. At the final follow-up, the following parameters were assessed and documented: the appearance and texture of flaps, the sensory recovery of the affected finger transplanted with the posterior arm cutaneous nerve using the British Medical Research Council sensory function assessment criteria, the dorsiflexion of the affected finger transplanted with the triceps brachii aponeurosis, the survival of the bone flaps confirmed via X-ray examination, the scar formation at the donor sites of skin flaps, and the function of the affected fingers evaluated based on the trial standard for functional evaluation of the upper limb of the Hand Surgery Society of the Chinese Medical Association.  Results  Postoperatively, the tissue flaps survived well. The pedicles of the lobulated flaps were successfully divided under local anesthesia 4 weeks after surgery. The follow-up duration ranged from 10 to 24 months, with an average of 13.5 months. At the final follow-up, the color and texture of the flaps were good, the sensation of the affected fingers transplanted with posterior arm cutaneous nerve recovered to S2-S3 level, the affected fingers transplanted with triceps brachii aponeurosis all achieved limited improvement in dorsiflexion, X-ray examination showed that the bone flaps survived; linear scars formed at the donor sites of skin flaps after wound healing, and the function of the affected fingers was evaluated as excellent in 5 cases and good in 3 cases.  Conclusions  The lateral arm tissue is rich in perforators and has few anatomical variations, which can be prepared into lobulated flaps and chimeric osteocutaneous flaps for the repair of complex finger wounds. The surgical operation is relatively simple, and the appearance and function of the donor and recipient sites are relatively good after surgery.

     

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