摘要
目的探讨U-Ⅰ型血管蒂筋膜瓣加游离植皮修复手指背侧中远节软组织缺损的临床效果。方法 14例(14指)手指背侧中远节软组织缺损患者,缺损范围为(2.0 cm×1.0 cm)^(4.0 cm×2.5 cm),取带掌背动脉的U-Ⅰ筋膜瓣修复创面后游离植皮,供区原位缝合。结果本组切取筋膜瓣范围为(2.2 cm×1.2 cm)^(4.5 cm×2.8 cm)。13例筋膜瓣全部成活,1例术后皮片边缘部分坏死,经换药后Ⅱ期愈合。供区均愈合良好。术后随访14例,平均8(3~18)个月。手指背侧外形丰满,不臃肿,供区外形满意,两点辨别觉平均8.5(7~11)mm;手指运动功能评价:优10例,良4例。结论 U-Ⅰ型掌背动脉筋膜瓣血管蒂长,转移覆盖范围较大,供区影响小,术后外形良好,是修复示、中、环指背侧中远节软组织缺损的一种较好的方法 。
Objective To investigate the clinical effects of U-I dorsal metacarpal artery pedicled fascia flap and free skin graft technique in the repair of soft tissue defect of the middle and distal phalanx.Methods14 patients（14 fingers） with soft tissue defect of the middle and distal phalanx were repaired by the U-I dorsal metacarpal artery pedicled fascia flap and free skin graft.The defect area was ranged from 2.0 cm×1.0 cm to 4.0 cm×2.5 cm.Results The area of fascia flap was ranged from 2.2 cm×1.2 cm to 4.5 cm×2.8 cm.The flaps survived in 13 cases,but partial necrosis of flap edge was found in 1 case and achieved secondary healing after changing dressings.And all donor sites healed well.14 patients were followed up for 3 to 18 months with an average of 8 months.The fingers showed satisfactory appearance without bloated shape.The static two point discrimination was 7 to 11 mm（average 8.5 mm）.The motor function evaluation of the fingers revealed excellence in 10 and good in 4.Conclusion U-I dorsal metacarpal artery pedicled fascia flap is a better way for repairing soft tissue defect of the middle and distal phalanx with many advantages such as long vascular pedicles,large rotate and coverage area,little influence on the donor sites and satisfactory shapes.
出处
《中国现代手术学杂志》
2010年第5期367-369,共3页
Chinese Journal of Modern Operative Surgery
关键词
外科皮瓣
软组织损伤
指损伤
surgical flaps
soft tissue injuries
finger injuries
