摘要
目的探讨带指动脉神经的指背岛状皮瓣修复指端缺损的方法和疗效。方法2011年6月至2012年9月，对15例18指指端皮肤缺损患者，以一侧指固有动脉神经背侧支为营养支，于远指间关节背侧设计皮瓣，带一侧指动脉神经，皮瓣旋转90°修复指端皮肤缺损，指背供区取上臂全厚皮片游离植皮。皮瓣携带指固有神经背侧支重建感觉。结果术后15例18指皮瓣均存活。随访时间为6—12个月，皮瓣质地外观良好，感觉恢复至S3～S4，两点分辨觉为4～8mm，患指指间关节主动活动度恢复优良。结论采用指动脉神经的指背岛状皮瓣修复指端缺损，操作简单，不牺牲指固有动脉、神经，血供可靠，供区损伤小，并能重建感觉，是一种修复指端缺损的理想方法。
Objective To introduce the surgical procedure of dorsal digital neurovascular island flap transfer for covering fingertip defects and evaluate the treatment outcomes. Methods From June 2011 to September 2012, 15 cases （18 digits） of fingertip defects were treated with dorsal digital neurovascular island flap. The flap was designed on the dorsal side of distal interphalangeal joint pedicled by unilateral dorsal branch of the proper digital artery and nerve which was also included in the flap. The flap was then elevated and rotated by 90° to cover the fingertip defect. The donor site was covered by full thickness skin graft from ipsilateral medial ann. The dorsal branch of proper digital nerve was included in the flap to restore sensation. Results All 18 flaps survived. Postoperative follow-up period was 6 to 12 months. All these flaps recovered with satisfying appearance and quality, excellent sensation with grade S3 to S4 and 4 to 8 mm two-point discrimination. Range of motion （ROM） of the interphalangeal joint of the injured finger was good. Conclusion Dorsal digital neurovasetdar island flap transfer is an ideal method for repairing fingertip defects. The surgery is simple. Reliable blood supply and sensation can be achieved without sacrificing the proper digital artery and nerve. There is minor donor site damage and very few complications.
出处
《中华手外科杂志》
CSCD
北大核心
2013年第5期280-282,共3页
Chinese Journal of Hand Surgery
