摘要
目的比较以一侧血管神经束为蒂的旋转皮瓣和推进皮瓣修复指端缺损的临床疗效。方法回顾性分析2018年1月-2021年6月采用以一侧血管神经束为蒂的旋转皮瓣和推进皮瓣修复的50例指端缺损患者的临床资料。其中旋转皮瓣组(以下简称旋转组)25例(28指),推进皮瓣组(以下简称推进组)25例(25指),术后均随访12~18个月,平均13.5个月。对比两组手术时间、术后12个月两点辨别觉和关节功能恢复情况。结果手术时间比较:旋转组(38.07±4.71)min,推进组(48.40±4.76)min,两组数据的差异具有统计学意义(t=-7.033,P<0.05),旋转组皮瓣在手术时间上明显优于推进组;术后12个月皮瓣两点辨别觉恢复情况比较:旋转组(5.39±1.16)mm,推进组(10.74±1.62)mm,差异具有统计学意义(t=-13.910,P<0.05),旋转组术后指端感觉恢复效果好,两点辨识度高;旋转组术后手指屈伸功能良好,掌指关节活动度比较两组数据差异无统计学意义(t=-0.228,P>0.05),而近节指间关节和远节指间关节活动度方面旋转组均优于推进组(t=3.475,2.112,P<0.05),手指关节活动的总评分中,也是旋转组优于推进组(t=4.151,P<0.05)。结论以一侧血管神经束为蒂的旋转皮瓣手术范围局限,创伤较推进皮瓣小,感觉功能恢复明显优于推进皮瓣,适合临床应用推广。
Objective To compare the clinical effects of rotating flap with one vascular nerve bundle as the pedicle and advancing flap for repair of finger defects.Methods A retrospective analysis was performed from 2018/1 to 2021/6 Since then,our department has used the rotating flap of one vascular nerve bundle as the pedicle and advancing flap for repair of finger defects in 50 clinical data.Among them,25 cases(28 fingers)in the rotating flap group(hereinafter referred to as the rotation group)and 25 cases(25 fingers)in the advancing flap group(hereinafter referred to as the advancement group),both groups were followed up for 12~18 months after surgery,average 13.5 months.The operation time,two points of discrimination 12 months after surgery,and joint function recovery were compared between two groups.Results Surgical time rotation group(38.07±4.71)min,the advancement group(48.40±4.76)min,the difference between two sets of data was statistically significant(t=-7.933,P<0.05),the rotation group flap was significantly better than the advancement group in terms of surgical time.Postoperative two-point discrimination,the rotation group flap(5.39±1.16)mm,the advancement group(10.74±1.62)mm,the difference was statistically significant(t=-13.910,P<0.05),the recovery effect of the finger sensation after rotating flap surgery was good,and two points were highly recognizable.In the rotation group the finger flexion and extension function was good after flap surgery,and there was no significant difference in the data of metacarpophalangeal range of motion(t=-0.228,P>0.05),while the range of motion of the proximal and distal interphalangeal joint function recovery the rotation group was superior to the advancement group(t=3.475,2.112,P<0.05),in the overall score of finger joint activity,the rotation group was also superior to the advancement group(t=4.151,P<0.05).Conclusion Due to the limited scope of surgery,the sensory function recovery of the rotating group flap with one vascular nerve bundle as the pedicle is significantly b
作者
戴平
钱源源
张建超
钟贤
钱达
徐晓晨
陆辉
于斌
DAI Ping;QIAN Yuanyuan;ZHANG Jianchao(Department of Plastic Hand and Foot Surgery,First People's Hospital of Changshu City,Changshu Hospital Affiliated to Soochow University,Jiangsu,215500,China)
出处
《实用手外科杂志》
2023年第3期307-310,共4页
Journal of Practical Hand Surgery
基金
常熟市卫生健康委员会科技计划项目(项目编号:CSWS2020005)。
关键词
手损伤
创伤修复
皮瓣
血管神经束
手指
Hand injury
Wound healing
Flap
Vascular nerve bundles
Finger
