摘要
目的系统随访指根部逆行岛状皮瓣修复指腹后的感觉恢复情况,为探讨重建指腹的最佳术式提供参考。方法自2015年9月至2019年5月,我们对47例行指根部逆行岛状皮瓣修复指腹缺损的患者进行感觉随访。其中縫合指固有神经20例,缝合指固有神经背侧支27例。皮瓣面积为3.0 cm×2.5 cm~1.5 cm×1.0 cm。感觉随访内容包括单丝触觉、英国医学研究委员会感觉分级(S_(0)-S_(4))、两点分辨觉。结果所有患者在术后3、6、9、12个月均获得随访,最长随访至术后30个月,平均(15.3±0.3)个月。术后12个月感觉恢复情况:S_(1)6例,S_(2)6例,S_(3)28例,S_(3+)7例。其中31例超过12个月以上的系统随访,感觉分级结果在12个月以后无明显进展。S_(3+)的7例患者两点分辨觉为9~15 mm,皮瓣的面积为1.5 cm×1.0 cm~1.8 cm×1.3 cm。其中缝合指固有神经背侧支的4例,测得两点分辨觉为11~13 mm,皮瓣面积为1.5 cm×1.0 cm~1.5cm×1.5 cm。结论指根部逆行岛状皮瓣在修复术后30个月内,感觉较难恢复到S,,小面积的皮瓣感觉恢复更好,缝合指固有神经或指固有神经背侧支对皮瓣感觉恢复无明显影响。
Objective To study the best surgery option for repairing finger pulp dfpfects by ollow-up of the sensory recovery of the finger pulp defects repaired by the reverse digital artery island flap.Methods From September 2015 to May 2019,47 patients with fingertip dects treated by reverse digital artery island flap were follow-up of sensory recovery.Among them,the proper digital nerve was sutured in 20 cases and the dorsal branch of the proper digital nerve was sutured in 27 cases.The flap area ranged from 1.5 cm×1.0 cm to 3.0 cm×2.5 cm.The sensory follow-up included Monofilament touch,sensory grading of Brtish Medical Research Council standard(S_(0)to S_(4))and two-point discrimination(2-PD).Results All the patients were follow-up at 3,6,9 and 12 months after operation.The longest follow-up period was 30 months with an average of(15.3±0.3)months.Twelve months after operation,there were 6 cases ofS_(1),6 cases of S_(2),28 cases ofS_(3),and 7 cases ofS_(3).Among them,31 cases were follow-up for more than 12 months,and there was no significant progress in sensory grading after 12 months.In 7 patients with S_(3+),the 2-PD was 9 to 15 mm,and the Aap area was 1.5 cm×1.0 cm to 1.8 cm×1.3 cm.For the 4 cases with suturing the dorsal branch of the proper digital nerve,the 2-PD was 11 to 13 mm and the flap area was 1.5 cm×1.0 cm to1.5 cmx1.5 em.Conclusion I is difcult for the reverse island flap to recover to S,within 30 months after the repair.The small area fap has better sensory recovery.There is no significant efct on the sensory recovery of the flap by suturing the proper digital nerve or the dorsal branch of the proper digital nerve.
作者
施海峰
芮永军
沙一帆
黄永静
王天放
李乾
吴柯
沈泳
杨惟翔
寿奎水
Shi Haifeng;Rui Yongjun;Sha Yifan;Huang Yongjing;Wang Tianfang;Li Qian;Wu Ke;Shen Yong;Yang Weixiang;Shou Kuishui(Department of Hand Surgery,Wuxri No.9 Hospital Afiliated to Suzhou University,Wuxi 214062,China)
出处
《中华手外科杂志》
CSCD
北大核心
2022年第1期5-8,共4页
Chinese Journal of Hand Surgery
关键词
指损伤
外科皮瓣
感觉随访
两点分辨觉
Finger injuries
Surgical flaps
Sensory follow-up
Two point discrimination
