摘要
目的应用以指背筋膜为蒂、带指固有神经背侧支的指背筋膜逆行岛状皮瓣修复指腹缺损。方法根据指背皮肤的血供特点,于手指近节中、远段及近节指间关节背侧设计皮瓣,皮瓣侧缘不超过手指侧中线,轴点位于远侧指间关节背桡侧或背尺侧,轴心线与手指纵轴平行。切取的皮瓣内含带指固有神经背侧支,在皮瓣转位后将其与创面指固有神经断端吻合。1997年11月～2001年4月,应用该术式修复手指指腹缺损27例28指。急诊手术24例,择期手术3例。皮瓣面积为1.8cm×1.5cm～2.5cm×2.2cm,蒂长1.5～2.2cm。结果皮瓣全部成活。随访7～32个月,平均21个月。修复后的指腹外观良好,质地柔软、耐磨,无明显触痛,静止两点辨别觉达3.5～6.5mm。供区无明显并发症,指间关节活动正常。结论此术式不损伤手指主要血管、神经,简单、安全,一次完成,不妨碍其他手指活动,重建的指腹感觉恢复满意。
Objective To utilize a reversed digital dorsal fascial vascular pedicled island fa scial flap with the dorsal branch of the proper d igital nerve to repair finger pulp defect.Methods Based on the features of blood supply of the dorsa l skin of the finger,the flap was designed on the proximal phalanx at the middle and distal segments and the dorsum of the proximal interphalangeal joint.The lateral margins of the fl ap did not cross the midlateral line,th e axial point was designed on the ulnar or the radial dorsum of the distal interphalangeal joint.The axis was paralleled to the longitudinal axis of finger.The dorsal branch of the pr oper digital nerve in the flap was sutured to the end of the proper digital nerve of injured site.From November 1997to April 2001,28pulp defects in 27cases were repaired with this method.E mergency operations were per-formed in 24cases and selective operations in 3.The flaps measured 1.8cm×1.5cm -2.5cm ×2.2cm and the length of pedicle was 1.5-2.2cm.Results All flaps survived completely.The p atients were followed up for 7to 32months,with an average o f 21months.The pulps after reconstr uction had good appearance,soft texture with wear-resisting.T here was no touch pain.Static two-point discrimination was 3.5-6.5mm.Conclusion The operation does not damage the major artery and nerve of the wounded fin ger.It is simple and safe,and can be done at one settin g.It does not interfere with the function of other digits.The sensation of the reconstructed pulp can be satisfactorily recovered.[
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2002年第7期390-393,共4页
Chinese Journal of Orthopaedics
