摘要
目的:探讨指动脉背侧支皮瓣与邻指皮瓣瓦合修复手指末节撕脱伤的临床疗效。方法:2019年3月至2023年6月,采用同指指动脉背侧支皮瓣和邻指皮瓣瓦合修复手指末节脱套伤或无再植条件断指患者13例,其中男11例,女2例;年龄21~55岁。伴有末节骨折6例,损伤平面均为远指间关节以远,缺损面积2.0 cm×3.4 cm~3.3 cm×4.1 cm。受伤至手术时间为2.5~8.0 h。结果:13例患者皮瓣均成活,随访6~18个月。末次随访时,皮瓣外形饱满,无显著瘢痕挛缩。伤指指间关节主动屈伸活动良好,无受限。皮瓣两点间辨别觉距离4~9 mm,感觉恢复至S2级7例,S3+级6例。根据中华医学会手外科学会上肢部分功能评定优10例,良3例。结论:同指指动脉背侧支皮瓣瓦合邻指皮瓣,修复手指末节脱套伤是传统皮瓣的组合,具有三维重建的能力,皮瓣供区组织损伤小,符合皮瓣治疗宁简勿繁原则。
Objective To investigate the clinical efficacy of combined dorsalis branch of digital artery flap and cross-finger flap in the repair of avulsion injury of the distal phalanx of the finger.Methods Between March 2019 and June 2023,13 patients with degloving injury of the distal phalanx of the finger or amputated finger without replantation conditions were treated with combined homodigital dorsalis branch of digital artery flap and cross-finger flap,including 11 males and 2 females,aged from 21 to 55 years old.Among them,6 cases were complicated with distal phalanx fracture.The injury level was all distal to the distal interphalangeal joint,and the defect area ranged from 2.0 cm×3.4 cm to 3.3 cm×4.1 cm.The time from injury to surgery was 2.5 to 8.0 hours.Results All flaps survived in the 13 patients,with a follow-up period ranging from 6 to 8 months.At the final follow-up,the flaps had a plump appearance without significant scar contracture.The active flexion and extension of the interphalangeal joints of the injured fingers were good without restriction.The two-point discrimination distance of the flaps was 4 to 9 mm;sensory recovery reached S2 grade in 7 cases and S3+grade in 6 cases.The clinical efficacy was evaluated according to the Trial Criteria for Upper Extremity Functional Assessment of the Chinese Society for Hand Surgery,with 10 cases rated as excellent and 3 as good.Conclusion Combination of the homodigital dorsalis branch of digital artery flap with the cross-finger flap for repairing degloving injury of the distal phalanx of the finger is a combination of traditional flaps,which has the capability of three-dimensional reconstruction,causes minimal tissue damage at the flap donor site,and conforms to the principle of"prioritizing simplicity over complexity"in flap therapy.
作者
赵惠民
赵光远
Zhao Huimin;Zhao Guangyuan(Department of Hand and Foot Surgery,Harbin Orthopedics Hospital,Harbin 150080,Heilongjiang,China)
出处
《中国骨伤》
2026年第1期95-99,共5页
China Journal of Orthopaedics and Traumatology
关键词
指动脉背侧支皮瓣
邻指皮瓣
手指末节
撕脱伤
Digital artery dorsal branch flap
Cross-finger flap
Fingertip
Avulsion injury
