摘要
目的探讨游离带阔筋膜的股前外侧皮瓣修复手背伸肌腱及软组织缺损的手术方法和临床效果。方法自2014年2月至2016年7月,对13例手背软组织及伸肌腱缺损患者采用游离带阔筋膜的股前外侧皮瓣修复,软组织缺损面积5.0cm×6.0cm^9.0cm×12.0cm,均合并指伸肌腱缺损及骨外露,皮瓣切取面积为6.0cm×7.0cm^10.0cm×13.0cm,阔筋膜切取面积3.0cm×4.0cm^6.0cm×8.0cm。术后定期随访。结果13例皮瓣全部成活,供区均未植皮,切口均一期愈合,随访6~36个月,平均13个月。皮瓣外形良好,皮肤色泽、质地接近手背皮肤,3例女性患者因皮瓣臃肿不满意,行二次手术修薄术,术后恢复满意。手指屈、伸活动良好,供区愈合良好,行走功能无影响。按中华医学会手外科学会上肢部分功能评定试用标准评定疗效(手功能评定试用标准),优8例,良4例,可1例。结论游离带阔筋膜的股前外侧皮瓣可以一次完成对手背伸肌腱及软组织缺损的修复。
Objective To explore the surgical technique and clinical effects of free anterolateral thigh flaps with fascia lata for repair of dorsal tendon and soft tissue defect of ophisthenar.Methods From February,2014 to July,2016,dorsal tendon and soft tissue defect of ophisthenar in 13 cases was repaired by free anterolateral thigh flaps with fascia lata.The area of soft tissue defect was 5.0 cm×6.0 cm-9.0 cm×12.0 cm.Extensor tendon defect and bone exposure occurred in all cases.The area of flap was 6.0 cm×7.0 cm-10.0 cm×13.0 cm,while the area of anterolateral thigh flap was 3.0 cm×4.0 cm-6.0 cm×8.0 cm.The regular post-operatively followed-up was performed.Results All flaps survived.The donor sites healed well without skin graft.The followed-up time was 6-36 months with the average of 13 months.The appearance of the flap was good.The color and texture of flaps was similar to the dorsal skin of ophisthenar.Three female patients who were not satisfied with the flap appearance received the revision and the results were satisfactory.The activity of finger flexion and extension was satisfactory.All patients walked well without difficulty.According to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association,the function recovery result was excellent in 8 cases,good in 4 cases,and poor in 1 case.Conclusion It is a good method to use the free anterolateral thigh flaps with fascia lata to repair of dorsal tendon and soft tissue defect of ophisthenar.
作者
熊胜
巨积辉
金光哲
唐林峰
张广亮
李祥军
王本元
Xiong Sheng;Ju Jihui;Jin Guangzhe;Tang Linfeng;Zhang Guangliang;Li Xiangjun;Wang Benyuan(Department of Hand Surgery,Ruihua Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215104,China)
出处
《中华显微外科杂志》
CSCD
北大核心
2019年第2期132-135,共4页
Chinese Journal of Microsurgery
基金
江苏省自然科学基金项目(BK20151203).
关键词
股前外侧皮瓣
阔筋膜
手背
软组织缺损
肌腱缺损
修复
Anterolateral thigh flap
Fascia lata
Opisthenar
Soft tissue defect
Tendon defect
Repair
