摘要
目的探讨以拇指桡侧指动脉关节皮支为蒂岛状皮瓣修复同指指腹缺损的临床效果。方法 2009年6月-2010年3月,收治10例10指拇指指腹缺损患者。男6例,女4例;年龄13～68岁,平均38岁。致伤原因:挤压伤4例,电刨伤3例,慢性感染2例,烫伤1例。末节指腹皮肤软组织缺损伴骨或肌腱外露4例,皮肤软组织缺损范围为1.0cm×0.8cm～2.0cm×1.4cm;近节指腹皮肤软组织缺损伴骨或肌腱外露6例,皮肤软组织缺损范围为1.0cm×0.8cm～2.5cm×2.0cm。病程3h～4个月。4例末节指腹缺损采用大小为1.0cm×0.8cm～2.2cm×1.5cm的拇指桡侧指动脉指间关节皮支为蒂岛状皮瓣修复;6例近节指腹缺损采用大小为1.0cm×0.8cm～2.6cm×2.2cm的拇指桡侧指动脉掌指关节皮支为蒂岛状皮瓣修复。供区游离植皮修复。结果术后皮瓣及植皮均顺利成活,创面Ⅰ期愈合。10例均获随访,随访时间6～12个月,平均8个月。皮瓣质地柔软,指腹外形无臃肿,颜色与患指周围皮肤相似。末次随访时皮瓣两点辨别觉为7～10mm。拇指功能根据总主动活动度(TAM)法评定,获优8例,良1例,可1例,优良率90%。结论拇指桡侧指动脉关节皮支为蒂岛状皮瓣不损伤拇指指动脉和指神经,手术操作简便,可较好修复拇指指腹缺损。
Objective To investigate the effectiveness of the island flap pedicled with the dorsal cutaneous branches of thumb radial digital artery from the same finger for repairing pulp defect.Methods Between June 2009 and March 2010,10 patients（10 fingers） with pulp defect of thumb were treated.There were 6 males and 4 females,aged 13-68 years with an average of 38 years.Defect was caused by machine crush in 4 cases,by saw machine in 3 cases,by chronic infection in 2 cases,and by burn in 1 case.The disease duration was 3 hours to 4 months.In 4 cases of distal pulp defect（1.0 cm × 0.8 cm to 2.0 cm × 1.4 cm） with exposure of bone or tendon,defect was repaired with island flap pedicled with the interphalangeal joint cutaneous branches of thumb radial digital artery（1.0 cm × 0.8 cm to 2.2 cm × 1.5 cm）.In 6 cases of proximal pulp defect（1.0 cm × 0.8 cm to 2.5 cm × 2.0 cm） with exposure of bone or tendon,defect was repaired with island flap pedicled with the metacarpophalangeal joint cutaneous branches of thumb radial digital artery（1.0 cm × 0.8 cm to 2.6 cm × 2.2 cm）.The donor sites were repaired with skin grafts.Results All flaps and skin grafts survived,and wounds healed by first intention.Ten cases were followed up 6-12 months（mean,8 months）.The colour,texture,and contour of the flaps were good.The two-point discrimination was 7-10 mm on the island flap at last follow-up.According to total active motion（TAM） standard,the thumb function was assessed as excellent in 8 cases,good in 1 case,and fair in 1 case,and the excellent and good rate was 90%.Conclusion The main digital artery and nerve of thumb will not be sacrified when the island flap pedicled with the dorsal cutaneous branches of thumb radial digital artery is used.The operative procedure is simple,so it is a good method for repairing pulp defect of thumb
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第9期1036-1039,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
拇指指腹缺损
拇指桡侧指动脉关节皮支
岛状皮瓣
创面修复
Pulp defect of thumb Dorsal cutaneous branches of thumb radial digital artery Island Wound repair
