title: [APPLICATION OF WRIST CREASE ISLAND FLAP BASED ON THE SUPERFICIAL PALMAR BRANCH OF THE RADIAL ARTERY FOR THUMB RECONSTRUCTION].
abstract: OBJECTIVE
  To investigate the effectiveness of the island flaps based on the superficial palmar branch of the radial artery (SPBRA) to repair the thumb wound.
  
  
  METHODS
  Between February 2012 and November 2013, 8 cases of thumb defects and bilateral artery defect were treated. There were 5 males and 3 females with an average age of 30.5 years (range, 19-51 years). The injury was caused by crush (4 cases), avulsion (3 cases), and twist (1 case). The injury located at the metacarpophalangeal joints in 3 cases, at the proximal palmar side in 2 cases, and at the interphalangeal joints in 3 cases. The defect size ranged from 3.5 cm x 1.5 cm to 6.5 cm x 2.0 cm. The digital artery defect was 2.5-8.5 cm (mean, 5.3 cm). The disease duration was 2.0-4.5 hours (mean, 3.2 hours). The reversed island flaps based on the SPBRA were designed, which size was 4.0 cm x 2.0 cm to 7.5 cm x 3.0 cm. The donor sites were closed directly.
  
  
  RESULTS
  The operation was successfully completed in 7 patients except 1 patient having vascular variation. All flaps survived completely. Wound and incision at the donor site healed by first intention. All patients were followed up 6-18 months (mean, 13 months). The flaps had similar color and texture to adjacent skin. Linear scar was seen at the donor site in 1 patient, with no functional limitation. According to the functional assessment criteria of upper limb by the Hand Surgery Branch of Chinese Medical Association, the results were excellent in 6 cases, good in 1 case, and fair in 1 case, with an excellent and good rate of 87.5%.
  
  
  CONCLUSIONS
  The reversed island flap based on the SPBRA is an ideal flap for the thumb reconstruction because the advantages of reliable blood supply, easy dissection, less injury at donor site, and good repair results.
authors.lastname: Zheng Dawei
authors.forename: Zhangcan
authors.initials: Z
authors.lastname: Li
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Xuyang
authors.initials: X
authors.lastname: Zhang
authors.forename: Rongjian
authors.initials: R
authors.lastname: Shi
authors.forename: Feng
authors.initials: F
authors.lastname: Sun
authors.forename: Kuishui
authors.initials: K
authors.lastname: Shou
mesh_terms: D002921:Cicatrix; D005260:Female; D005383:Finger Injuries / Q000601:surgery; D006230:Hand Injuries; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint; D017534:Radial Artery / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012867:Skin; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D013710:Tendons / Q000601:surgery; D013933:Thumb / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D034941:Upper Extremity; D014945:Wound Healing; D014953:Wrist; D014954:Wrist Injuries / Q000601:surgery*; D014955:Wrist Joint