摘要
目的对比指掌侧固有动脉穿支皮瓣与[足母]趾腓侧皮瓣修复手指软组织缺损的临床疗效。方法回顾2017年1月至2019年1月收治的手指软组织缺损伤患者52例,其中采用指掌侧固有动脉穿支皮瓣修复27例,[足母]趾腓侧皮瓣修复25例。两组患者均为单纯软组织缺损,不合并指骨骨折。患者出院后通过电话、微信及门诊进行随访。手指感觉功能恢复按中华医学会手外科学会断指再植评定试用标准进行评价。皮瓣优良程度依据皮瓣外形、患者满意度、手指功能进行整体评价,并依次分为优、良、可、差四个等级。收集两组患者以上数据并进行统计学分析,统计软件采用SPSS 22.0进行计算分析。P<0.05为差异有统计学意义。结果两组患者均得到随访,随访时间12~16个月。两组皮瓣均成活,[足母]趾腓侧皮瓣修复组TPD为4~7(5.3±1.2)mm,指掌侧固有动脉穿支皮瓣修复组TPD为6~10(8.4±1.7)mm,两组间差异有统计学意义(t=7.642,P=0.000)。根据中华医学会手外科学会断指再植评定试用标准,指掌侧固有动脉穿支皮瓣修复组:优17指,良6指,可4指,优良率85.1%;[足母]趾腓侧皮瓣修复组:优8指,良5指,可9指,差3指,优良率52.0%,两组差异有统计学意义(t=6.710,P=0.009)。对比两组并发症发生率,指掌侧固有动脉穿支皮瓣和[足母]趾腓侧皮瓣修复组并发症发生率分别为3.7%和25.9%,两组间差异有统计学意义(t=4.167,P=0.032)。结论指掌侧固有动脉穿支皮瓣及[足母]趾腓侧皮瓣均为修复手指软组织缺损的良好选择,但[足母]趾腓侧皮瓣术后并发症发生率较高,因此,在临床工作中需根据自身情况进行选择。
Objective To compare the clinical effect of perforator flap of proper palmar digital and hallex fibular flap in repair of soft tissue defect of fingers.Methods A total of 52 patients with finger soft tissue injury were reviewed from January,2017 to January,2019.Twenty-seven patients were repaired by perforator flap of proper palmar digital artery,and 25 by hallex fibular flaps.Both groups of patients had only soft tissue defects without phalangeal fracture.Postoperative follow-up were conducted by phone,WeChat and visit of outpatient clinic.The recovery of finger sensory function was evaluated according to the Trial Standard for Replantation Evaluation of Severed Digit by the Hand Surgery Society of Chinese Medical Association.The flaps were evaluated according to the shape,patient satisfaction and finger function and classified in excellent,good,fair and poor.Data of the 2 groups of patients were collected and statistically analysed by SPSS 22.0.P<0.05 was statistically significant.Results Both groups entered follow-up for 12-16 months.All flaps in both groups survived.There was statistically significant difference of TPD between the 2 groups[TPD were 4-7(5.3±1.2)mm and 6-10(8.4±1.7)mm,respectively](t=7.642,P=0.000).According to the Evaluation Criteria of the Hand Surgery Society of the Chinese Medical Association.In the group repaired by perforator flap of proper palmar digital artery,17 fingers were excellent,6 good,and 4 fair,with a 85.1%of excellent and good rate.In the group repaired by hallex fibular flap,8 fingers were excellent,5 good,9 fair,and 3 poor,with a 52.0%of excellent and good rate.The difference between 2 groups was statistically significant(t=6.710,P=0.009).There was a 3.7%incidence of complications in the group repaired by perforator flap of proper palmar digital artery,and 25.9%in the group repaired by hallex fibular flap.The difference between the 2 groups was statistically significant(t=4.167,P=0.032),and there was a higher incidence of complications in the group repaired by hallex fibul
作者
刘晓春
赵鹏
黄永军
牟勇
黄东
LIU Xiaochun;ZHAO Peng;HUANG Yongjun;MOU Yong;HUANG Dong(Department of Orthopaedics,The Second People's Hospital of Guangdong Province,Guangzhou 051000,China;Department of Orthopaedics,Kailuan General Hospital,Tangshan,Hebei Province 063000,China)
出处
《中华显微外科杂志》
CSCD
北大核心
2021年第5期491-494,共4页
Chinese Journal of Microsurgery
