[Repair of soft-tissue defects on volar aspect of fingers with medial plantar venous flap].
OBJECTIVE
To investigate the operative procedure and the short-term therapeutic effects of medial plantar venous flaps for restoration of soft-tissue defects on the volar aspect of fingers.


METHODS
From May 2007 to July 2009, 13 cases (15 fingers) ofvolar soft tissue defects were treated with medial plantar venous flaps, including 7 males (9 fingers) and 6 females (6 fingers) with an average age of 30 years (range, 17-55 years). Soft tissue defects were caused by electric saws in 4 cases (5 fingers), by crush injury in 6 cases (6 fingers), and by burned scar removal in 3 cases (4 fingers). The size of soft tissue defects ranged from 1.0 cm x 0.9 cm to 5.8 cm x 3.3 cm, included 5 thumbs, 3 index fingers, 3 little fingers, 2 ring fingers, and 2 middle fingers. The emergency surgical treatment was performed in 10 traumatic cases after 2 to 12 hours (4 hours on average); and the elective surgical treatment was performed in the other 3 cases of scar after burn. The 15 medial plantar venous flaps, with size of 1.0 cm x 1.0 cm to 6.0 cm x 3.5 cm, were harvested to restore defects. Of them, 12 venous flaps had 1 superficial vein and the other 3 had 2 veins; and the veins of 13 venous flaps bridged a single digital artery and the veins of the other 2 flaps bridged both arteries. The donor sites were sutured directly or were covered with skin graft.


RESULTS
All 15 venous flaps survived completely, and the donor and recipient sites healed by first intention. Eleven cases (11 fingers) were followed up for 2 to 12 months. The texture and color of the flaps were similar to those of adjacent normal skin with a satisfactory appearance. The two-point discrimination was 6-9 mm. According to criterion for joint junction of total active range of motion/total active range of flexion, the results were excellent in 10 cases and good in 1 case; the excellent and good rate was 100%.


CONCLUSIONS
The medial plantar venous flap has advantages of easy-to-operate, rich blood supply and high survival rate. So it is an ideal and reliable choice for volar soft tissue defects of fingers.
Hand and Foot Surgical Center, Provincial Hospital Affiliated to Shandong University, Jinan Shandong, 250021, PR China. sunwsea@126.com
Wenhai
W
Sun
Zengtao
Z
Wang
Shenqiang
S
Qiu
Shibing
S
Guan
Yong
Y
Hu
Lei
L
Zhu
Pelting
P
Liu
D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005528:Foot / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps; D014680:Veins / Q000637:transplantation; D055815:Young Adult