摘要
目的介绍(足母)趾腹皮瓣联合跖底皮瓣治疗手指严重屈曲挛缩畸形的临床应用。方法临床应用10例15指,患指均为远、近侧指间关节屈曲60°～90°,瘢痕切除手指伸直后遗留掌侧较大面积皮肤软组织缺损,并伴有肌腱指骨外露,创面大小6．0 cm×1．5 cm～8．0 cm×2．5 cm。在(足母)趾腹及其近侧跖底设计皮瓣,形状同手指创面,面积稍大,皮瓣切取时带趾背静脉及跖背或跖底动脉,分别与患指指背静脉及相应侧指固有或指掌侧总动脉吻合,皮瓣中动脉均桥接固有动脉以改善患指血运。结果术后皮瓣全部成活、皮瓣质地及外形好,皮瓣两点辨别觉5～7 mm。患指均可完全伸直,患指主、被动屈伸活动恢复满意。足部供区瘢痕轻微,外形美观,功能良好。结论(足母)趾腹皮瓣联合跖底皮瓣是治疗指掌侧严重瘢痕增生所致手指严重屈曲挛缩畸形的最佳皮瓣之一。
Objective To introduce the clinical application of curing severse phalangeal flexed contracture malformation with hallux pulp flap combined with plantar metatarsal flap. Methods From January 2001, To apply this method to 10 cases including 15 fingers. The flexion ange of proximal and distal interphalangeal joints ranged from 60° to 90°, and larger soft tissue defect of skin were left with tendons and phalanges exposed after fingers straightened by scar cutted, wound area ： 6.0 cm ×1.5 cm - 8. 0 cm ×2.5 cm , The flaps were designed on the thumb pulp and its proximal plantar, with the same shape as the wound and larger area, and the flap was cutted with dorsal digital veins, and proper digital artery, dorsal metatarsal or plantar metataesal artery. They were respectively anastomosed with dorsal digital veins, and proper digital artery or common palmar difital. The middle artery of flap was bridged with proper artery to improve blood circulation. Results All the flaps survived with good texture, good outlook, and two-point-discrimination up to 5 -7mm. Thus, all the injured fingers were extended completely, and the flexed and extended activites actively and passively recovered satisefiedly. The donor feet were with slight scar, good outlook and wonderful function. Conclusion Thumb pulp flap combined with plantar metatarsal flap is one of the optimum flaps to cure severe phalangeal flexed contracture malformation resulted form severe palmar digital scar hyperpaasia.
出处
《中华显微外科杂志》
CSCD
北大核心
2006年第4期245-247,i0001,共4页
Chinese Journal of Microsurgery
关键词
指
屈曲挛缩
外科皮瓣
移植
Finger
Flexed contracture
Surgical flap
Transplantation
