摘要
目的应用中指近节桡侧指动脉邻指逆行岛状皮瓣修复拇指指端缺损。方法对10例拇指指端缺损患者，以中指近节桡侧指动脉为血管蒂，以带蒂皮瓣的方式进行修复，供区直接闭合。皮瓣内含指固有神经背侧支，在皮瓣转位后将其与拇指指神经断端缝合重建皮瓣感觉。结果所有皮瓣存活良好，创面I期愈合。随访时间为3～12个月。指端外观良好，质地柔软，耐磨，无触痛，重建拇指指腹两点分辨觉为4～6mm，供区无明显并发症，指间关节活动正常。根据中华医学会手外科学会上肢部分功能评定试用标准评定：优9例，良1例。结论中指近节桡侧指动脉邻指逆行岛状皮瓣修复拇指指端缺损外形及感觉恢复良好，是一种简单实用的手术方法。
Objective To present the application of a radial digital artery reverse island flap from proximal phalange of the middle finger for repair of fingertip defect of the thumb. Methods Ten cases of fingertip defect of the thumb were treated with this flap that was based on radial digital artery at the proximal phalangeal level of the middle finger. The pedicled flap was transferred to the defect site. The donor site was directly closed. To restore sensation of the flap, the dorsal branch of the proper digital nerve was included in the flap and sutured to the proper digital nerve in the severed thumb stump. Results All the flaps survived completely. Incisions were healed by first intention. The patients were follow-up for 3 to 12 months. The thumbs had good appearance after the reconstruction. The flaps were supple and resistant to wear and tear. There was no touch pain. The two-point discrimination was 4 to 6 mm. There was no complication at the donor site and no limitation in the movement of the interphalangeal joint. According to the ftmctional evaluation criteria of the upper limb issued by the Hand Surgery Society of the Chinese Medical Association, active range of motion was rated as excellent in 9 cases and good in 1 case. Conclusion Transfer of the radial digital artery reverse island flap from proximal phalange of the middle finger to cover defects of the thumb tip can lead to good appearance and sensation. It is a simple and reliable operative method.
出处
《中华手外科杂志》
CSCD
北大核心
2014年第1期44-46,共3页
Chinese Journal of Hand Surgery
关键词
岛状皮瓣
外科手术
邻指皮瓣
拇指指端缺损
Island flaps
Surgical procedures, operative
Cross-finger flaps
Thumb fingertip defect
