摘要
目的：探讨以游离趾蹼皮瓣修复相邻两指腹创面的方法和临床效果。方法2010年4月至2012年8月，采用游离趾蹼皮瓣修复了7例相邻两指腹创面患者，均伴有深部指骨、肌腱等组织外露，术后随访观察皮瓣、供区愈合情况，检测关节总主动活动度（total active motion，TAM）、两点辨别觉（2－point discrimination，2－PD）等指标了解患指感觉、功能恢复情况。结果术后7例皮瓣全部成活，1例供区植皮部分坏死，经二期清创换药后愈合。术后均获随访，随访时间平均26个月，皮瓣质地、外形满意，供区瘢痕不明显，末次随访时（1年以上）：患指TAM 235°-265°（健侧255°-270°）；2－PD平均6．8 mm（4．5-8．5 mm），健侧平均4．1 mm（3．5-7．0 mm），供区对侧区平均9．5 mm（8．5-12．5 mm）。患者自我评价：好6例，中1例，差0例。结论游离趾蹼皮瓣修复相邻两指创面具有外形美观、感觉和功能恢复满意、供区损伤小等优点，是较理想的修复方案。
Objective To assess the application of free toe web flaps to repair finger pulp defect.Methods A total of seven patients underwent the surgery from April 2010 to August 2012 due to finger pulp defect, with the phalanges and tendon exposed.The postoperative follow-up schedule included observation of finger flap and wound healing at donor sites as well as detection of total active motion （TAM） and 2-point discrimination （2-PD） to assess sensory and func-tional recovery.Results All flaps survived after surgery, while one skin graft was partially necrotic but healed after sec-ondary debridement and dressing change.All patients were followed up during twenty-six months on average.The tex-ture and appearance of the flaps were satisfactory with an inconspicuous scar at donor sites.At the latest follow-up （ 1 year）, the affected finger has TAM of 235°-265°（255°-270°for the contralateral finger）; the mean 2-PD of 6.8 mm （4.5-8.5 mm, 4.1 mm on average for the contralateral finger, ranging from 3.5 mm to 7 mm）, and the mean con-tralateral area of 9.5 mm at donor sites （8.5-12.5 mm）.For patient self-assessment, six patients scored themselves as good, and one scored himself/herself as average, without poor evaluation.Conclusion Free toe web flaps can be a-dopted to repair finger pulps, with the advantages of beautiful appearance and satisfied sensory function recovery with less injury at donor sites.
出处
《徐州医学院学报》
CAS
2015年第6期386-389,共4页
Acta Academiae Medicinae Xuzhou
基金
徐州市医学青年后备人才培养工程基金（2014018）
关键词
外科皮瓣
趾蹼
指腹损伤
修复
surgical flaps
toe web
finger injury
reconstructio
