摘要
目的 探讨[足母]趾腓侧游离皮瓣结合指压力套修复手指远节指腹缺损的临床疗效。方法 采用[足母]趾腓侧游离皮瓣结合指压力套修复11例手指远节指腹缺损患者。指腹缺损面积2.0 cm×1.0 cm~4.0 cm×1.8 cm。切取皮瓣面积2.2 cm×1.2 cm~4.5 cm×2.2 cm。结果 皮瓣均成活。患者均获得随访,时间3~12个月。末次随访时,指腹皮瓣颜色红润,张力正常,外形饱满,有指螺纹,指腹两点辨别觉9~16 mm,皮瓣与患指皮肤缝合处瘢痕不明显,外形接近正常手指。[足母]趾供区一期缝合,其中2例皮瓣切取宽度>1.5 cm,缝合后张力过大,局部产生张力性水疱,拆除部分缝线后换药愈合,其余患者切口无红肿、破溃,愈合良好,无瘢痕挛缩、关节僵硬等并发症,步行均无异常。结论 采用[足母]趾腓侧游离皮瓣结合指压力套修复手指远节指腹缺损,能重建感觉,很好地恢复患指的外形、功能。
Objective To investigate the clinical efficacy of the free fibular flap of great toe combined with finger pressure sleeve for repairing the distal phalanx pulp defect of the finger.Methods The 11 patients with distal finger pulp defects were repaired with the free fibular flaps of great toes combined with finger pressure sleeve.The phalanx pulp defect area was 2.0 cm×1.0 cm~4.0 cm×1.8 cm,and cutting flaps area was 2.2 cm×1.2 cm~4.5 cm×2.2 cm.Results All flaps survived.All patients were followed up for 3~12 months.At the last follow-up,the phalanx pulp had a rosy color,normal tension,and a plump appearance with finger threads.The two-point discrimination on the finger pulp was 9~16 mm.The scar at the suture between the flaps and the affected finger were not obvious,and the appearance were similar to the normal finger.The donor site of great toe was sutured in the first stage,of which the cutting width of 2 cases of flaps were more than 1.5 cm,resulted local tension blisters after suturing,after removing some sutures,the wound healed after dressing.The other patients had no redness,swelling,rupture,with good healing,and no complications such as scar contracture or joint stiffness;walking was normal.Conclusions The free fibular flap of the great toe combined with finger pressure sleeve are used to repair the distal phalanx pulp defects of finger,which can effectively restore the appearance and function of the affected finger,and reconstruct sensation.
作者
李海建
李甲
王大伟
郑大伟
朱辉
赵春旭
LI Hai-jian;LI Jia;WANG Da-wei;ZHENG Da-wei;ZHU Hui;ZHAO Chun-xu(Dept of Hand Surgery,Xuzhou Renci Hospital,Xuzhou,Jiangsu 221000,China)
出处
《临床骨科杂志》
2023年第5期674-676,共3页
Journal of Clinical Orthopaedics
关键词
远节指腹缺损
[足母]趾腓侧
游离皮瓣
指压力套
distal phalanx pulp defect of finger
fibular side of great toe
free flap
finger pressure sleeve
