摘要
目的探讨改良前臂骨间背侧动脉穿支皮瓣修复手部软组织缺损的手术方式及临床疗效。方法根据前臂骨间背侧动脉中远端穿支位置及前臂背侧皮神经走行设计骨间背侧动脉穿支皮瓣,修复16例手腕、手背及虎口部皮肤软组织缺损患者。创面缺损面积:10 cm×7 cm^15 cm×13 cm,切取皮瓣面积:10 cm×8 cm^16 cm×14 cm。结果术后有3例皮瓣发生静脉危象,经保守治疗后创缘愈合。16例皮瓣全部成活。患者均获得随访,时间6~18个月。皮瓣外形无明显臃肿,质地良好,感觉恢复达S3+1例,S36例,S29例。根据中华医学会手外科学分会上肢部分功能评定标准评定:优10例,良4例,可2例。结论改良前臂骨间背侧动脉穿支皮瓣手术操作简单,风险较低,血管蒂可灵活设计,是修复手部软组织缺损较好的手术方式。
Objective To explore the surgical techniques and clinical effect of modified posterior interosseous artery distal perforator flap for repairing soft tissue defect of hand. Methods Using flaps to repair 16 cases of soft tissue defect of wrist,opisthenar and first web, flaps were designed according to the location of mid-distalis perforator of pos-terior interosseous artery and the route of antebrachii posterior neurocutaneous. The defect area was 10 cm x 7 cm ？ 15 cm x 13 cm,flaps area was 10 cm x 8 cm ？16 cm x 14 cm. Results After the operation, 3 cases of venous cri-sis occurred, and the wound were healed by conservative treatment. All 16 flaps survived completely,and follow-up time ranged from 6 months to 18 months. All flaps showed good texture matches and contour. The sensation of the flaps returned to S3 ＋ 1 case, S3 6 cases, S2 9 cases. According to the functional assessment criteria for upper extrem-ities issued by the Hand Society of the Chinese Medical Association, the results were excellent in 10 cases,good in 4, and fair in 2 . Conclusions Improved posterior interosseous artery perforator flap has the advantages of simple opera-tion ,lower risk and flexible design of vascular pedicle, which has good clinical effect to repair soft tissue defect of the hand.
出处
《临床骨科杂志》
2017年第2期245-247,共3页
Journal of Clinical Orthopaedics
关键词
前臂骨间背侧动脉
穿支皮瓣
前臂背侧皮神经
软组织缺损
手损伤
posterior interosseous artery
perforator flap
antebrachii posterior neurocutaneous
soft tissue defects
hand injuries
