title: A comparative study of four types of free flaps from the ipsilateral extremity for finger reconstruction.
abstract: OBJECTIVE
  To compare the outcomes of finger reconstruction using arterialized venous flap (AVF), superficial palmar branch of the radial artery (SPBRA) flap, posterior interosseous perforator flap (PIPF), and ulnar artery perforator free (UAPF) flap harvested from the ipsilateral extremity.
  
  
  METHODS
  We retrospectively reviewed the outcomes for 41 free flaps from the ipsilateral extremity in the reconstruction of finger defects in 41 patients with small/moderate skin defects, including 11 AVFs, 10 SPBRA flaps, 10 PIPFs, and 10 UAPF flaps. Standardized assessment of outcomes was performed, including duration of operation, objective sensory recovery, cold intolerance, time of returning to work, active total range of motion (ROM) of the injured fingers, and the cosmetic appearance of the donor/recipient sites.
  
  
  RESULTS
  All flaps survived completely, and the follow-up duration was 13.5 months. The mean duration of the complete surgical procedure for AVFs was distinctly shorter than that of the other flaps (p<0.05). AVFs were employed to reconstruct skin defects and extensor tendon defects using a vascularized palmaris longus graft in 4 fingers. Digital blood supply was reestablished in 4 fingers by flow-through technique when using AVFs. Optimal sensory recovery was better with AVFs and SPBRA flaps as compared with UAPF flaps and PIPFs (p<0.05). No significant differences were noted in ROM or cold intolerance between the 4 groups. Optimal cosmetic satisfaction was noted for the recipient sites of AVFs and the donor sites of SPBRA flaps. The number of second-stage defatting operations required for AVFs was considerably lesser than that for the other flaps.
  
  
  CONCLUSIONS
  All 4 types of free flaps from the ipsilateral extremity are a practical choice in finger reconstruction for small/moderate-sized skin defects. AVFs play an important role in such operations due to the wider indications, and better sensory recovery and cosmetic appearance associated with this method.
authors.affiliation: Department of Orthopedic and Traumatic Surgery, General Hospital of Jinan Military Command, Jinan, P. R. China; The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA, Qingdao, P. R. China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Liu
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA, Qingdao, P. R. China.
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Jiao
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA, Qingdao, P. R. China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Ji
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA, Qingdao, P. R. China.
authors.forename: Chunlei
authors.initials: C
authors.lastname: Liu
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA, Qingdao, P. R. China.
authors.forename: Xiaopen
authors.initials: X
authors.lastname: Zhong
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA, Qingdao, P. R. China.
authors.forename: Hongxun
authors.initials: H
authors.lastname: Zhang
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA, Qingdao, P. R. China.
authors.forename: Xiaohen
authors.initials: X
authors.lastname: Ding
authors.affiliation: Department of Orthopedic and Traumatic Surgery, General Hospital of Jinan Military Command, Jinan, P. R. China.
authors.forename: Xuecheng
authors.initials: X
authors.lastname: Cao
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012867:Skin
references.citation: Plast Reconstr Surg. 1987 Feb;79(2):243-50
references.pmid: 3809270
references.citation: J Hand Surg Am. 2012 May;37(5):1042-50
references.pmid: 22480502
references.citation: Ann Plast Surg. 2013 Jun;70(6):666-71
references.pmid: 23364671
references.citation: Hand Clin. 1985 Nov;1(4):677-83
references.pmid: 3831054
references.citation: Plast Reconstr Surg. 1997 Jan;99(1):116-21
references.pmid: 8982194
references.citation: Microsurgery. 2010;30(2):118-24
references.pmid: 19967760
references.citation: Aesthetic Plast Surg. 2014 Feb;38(1):156-163
references.pmid: 24441759
references.citation: Plast Reconstr Surg. 2006 Mar;117(3):920-6
references.pmid: 16525286
references.citation: Microsurgery. 1994;15(12):886-90
references.pmid: 7707931
references.citation: Plast Reconstr Surg. 2013 Feb;131(2):308e-309e
references.pmid: 23358046
references.citation: J Plast Reconstr Aesthet Surg. 2012 Sep;65(9):1220-6
references.pmid: 22583834
references.citation: Ann Plast Surg. 2010 Dec;65(6):535-40
references.pmid: 21042191
references.citation: J Hand Surg Eur Vol. 2010 Feb;35(2):125-9
references.pmid: 19687082
references.citation: Plast Reconstr Surg. 2007 Oct;120(5):1315-1321
references.pmid: 17898606
references.citation: Ann Plast Surg. 2013 Jul;71(1):72-5
references.pmid: 23503427
references.citation: Plast Reconstr Surg. 1983 Oct;72(4):439-47
references.pmid: 6351136
references.citation: Plast Reconstr Surg. 2007 May;119(6):1823-1838
references.pmid: 17440363
references.citation: Br J Plast Surg. 2001 Jul;54(5):390-5
references.pmid: 11428768
references.citation: Scand J Plast Reconstr Surg Hand Surg. 2002;36(6):362-7
references.pmid: 12564816
references.citation: J Trauma. 1991 Sep;31(9):1286-93
references.pmid: 1920561
references.citation: Ann Acad Med Singap. 1995 Jul;24(4 Suppl):108-12
references.pmid: 8572513
references.citation: J Hand Surg Br. 1996 Apr;21(2):222-9
references.pmid: 8732406
references.citation: J Trauma. 1974 Sep;14(9):756-63
references.pmid: 4411617
references.citation: World J Surg. 1991 Jul-Aug;15(4):458-62
references.pmid: 1891930
references.citation: Plast Reconstr Surg. 2004 Aug;114(2):411-20
references.pmid: 15277808
references.citation: J Hand Surg Am. 2005 Nov;30(6):1305-9
references.pmid: 16344193
references.citation: Br J Plast Surg. 1999 Jan;52(1):64-8
references.pmid: 10343593
references.citation: J Trauma. 2009 Aug;67(2):E48-50
references.pmid: 19667869
references.citation: J Plast Reconstr Aesthet Surg. 2009 Jul;62(7):e211-5
references.pmid: 19380263
references.citation: Surg Radiol Anat. 2013 Oct;35(8):737-40
references.pmid: 23443276
references.citation: Microsurgery. 1996;17(7):375-9
references.pmid: 9379885
references.citation: Plast Reconstr Surg. 1998 Apr;101(4):999-1005
references.pmid: 9514333
references.citation: Ann Plast Surg. 2006 Nov;57(5):552-6
references.pmid: 17060738
references.citation: J Reconstr Microsurg. 2010 Oct;26(8):529-38
references.pmid: 20648418