摘要
目的探讨第2趾胫侧游离皮瓣修复手指一侧指固有动脉、神经缺损合并皮肤软组织缺损的手术方法及临床疗效。方法应用第2趾胫侧游离皮瓣修复10例10指合并皮肤软组织、神经缺损的患者，其缺损面积最大为5．0Cm×2．0cm，最小为2．0CITI×1．5cm；以第2趾胫侧游离皮瓣内的轴心动脉及神经桥接修复指一侧固有动脉、神经的缺损，切取皮瓣的面积最大为5．5cm×2．2cm，最小为2．2cm×1．6cm，平均为3．5cm×1．7cm；指动脉、神经缺损的长度最大为5．0cm，最小为2．0cm，平均为3．5cm；第2趾供区切取同侧小腿内侧全厚皮片植皮修复。结果所有患者的移植皮瓣全部成活（I期愈合），小腿供区伤口I期愈合。术后获随访6～36个月，指端的两点辨别觉为6—10mm，平均为8mm；皮瓣的两点辨别觉为8—10mm，平均为9mm。足供区植皮愈合良好，无瘢痕挛缩及植皮区破溃，足功能无明显影响。结论应用第2趾胫侧游离皮瓣修复手指皮肤、神经缺损，可以恢复手指的外形及功能，是修复此类损伤较理想的方法。
Objective To report a surgical method and clinical efficacy of repairing skin and nerve defects of finger by the tibial free flap of the second toe. Methods Ten eases （ 10 fingers） with skin and nerve defects of finger by the tibial free flap of the second toe, the area of defects ranged from 2.0 cm x 1.5 em to 5.0 em x 2.0 era. The lateral inherent artery and nerve defects of finger were treated by the tibial free flap with axis artery and nerve of the second toe, the area of the flaps ranged from 2.2 cm x 1.6 cm to 5.5 cm x 2.2 cm （ the average area was 3.5 cmx 1.7 era）. The length of the artery and nerve defects of finger ranged from 2.0 cm to 5.0 em （average 3.5 era）. The donor defect was repaired with full thickness free skin from ipsilaterally inside leg. Re- suits All flaps survived primarily, and the donor wound healed primarily. After 6 to 36 months following up, the two-point discrimination of the fingertip was 6 to 10 mm （ average 8 mm） ; Two point discrimination of the flap was 8 to 10 mm （average 9 mm）. All grafted flaps healed well without cicatricial contracture, diabrosis and pedal function disturbation. Conclusion It is a reliable approach for repairing skin and nerve defects of finger with the tibial free flap of the second toe.
出处
《中国美容整形外科杂志》
CAS
2012年第9期548-551,共4页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
指损伤
外科皮瓣
移植
Finger injury
Surgical flaps
Grafting
作者简介
第一作者：李祥军（1981-），男，湖北十堰人，主治医师．
通信作者：巨积辉，215104，苏州大学附属瑞华医院手外科，电子信箱：jjh2006@263．net
