Tái tạo mất da lưng ngón cái bằng vạt da diều bay cải tiến lấy kèm nhánh thần kinh cảm giác: báo cáo ca lâm sàng và tổng quan y văn

Reconstruction of soft tissue defects involving the thumb, particularly those with exposed tendons or bones, presents a significant challenge in hand surgery. The thumb's central role in human hand function necessitates reconstructive approaches that not only provide durable coverage but also restore functional grip and sensory perception. The first dorsal metacarpal artery (FDMA) flap has emerged as a reliable option for hand reconstruction, offering versatility in addressing these complex injuries. Recent modifications, specifically the inclusion of a sensory nerve branch, have further enhanced its utility by promising improved sensory outcomes. This paper aims to present a clinical case demonstrating the application of a modified FDMA flap for dorsal thumb injuries and to review its advantages and outcomes in the context of modern reconstructive practices.

Hand surgeons, plastic surgeons, orthopedic residents, and researchers interested in reconstructive hand surgery and microsurgery techniques.

This paper details a successful hand reconstruction using a modified first dorsal metacarpal artery (FDMA) flap with sensory nerve branch harvesting to address dorsal thumb soft tissue defects involving exposed extensor tendons. The clinical case involves a 34-year-old female patient with a work-related injury to her left thumb. Following initial wound stabilization, a modified FDMA flap, incorporating the superficial sensory branch of the radial artery, was utilized for definitive coverage. This approach was chosen for its reliability and potential for restoring both tissue integrity and sensation in a critical area. Postoperative management included careful monitoring, systemic Papaverine to enhance flap viability, and intravenous Unasyl for infection prevention. The outcomes were highly favorable; the flap survived completely without necrosis or infection, the surgical site healed well, and the patient regained full functional grip and tactile sensation. Crucially, she returned to work within six months, demonstrating excellent functional recovery. The study emphasizes that this advanced flap surgery technique provides durable soft tissue coverage, enables effective sensory reinnervation, and yields positive aesthetic results. While acknowledging the limitations of a single case report and a relatively short follow-up period, the findings suggest that this modified FDMA flap should be considered a first-line option for complex dorsal thumb injuries requiring both soft tissue and sensory reconstruction, offering a comprehensive solution for challenging hand defects.