摘要
目的探讨以掌背动脉背侧皮支皮瓣修复手指中末节软组织缺损的方法和疗效。方法2015年5月至2017年3月，对21例手指中末节软组织缺损患者，以掌背动脉背侧皮支为蒂、掌横韧带以远掌背动脉与指总动脉吻合处为旋转点于手背设计掌背动脉背侧皮支皮瓣修复创面．皮瓣内携带掌背皮神经与患指指神经吻合重建感觉，供区均直接缝合。术后定期随访。结果术后20例皮瓣完全成活．1例皮瓣远端1／3坏死．经换药等对症处理后愈合。术后随访3—12个月，皮瓣质地、外观良好，感觉恢复至S3-S4，两点辨别觉为5-8mm。供区恢复良好，患指关节主动活动度恢复良好，优良率95．2％。结论应用掌背动脉背侧皮支皮瓣修复手指中末节软组织缺损，操作简单，不牺牲主干动脉、神经，血供可靠，供区损伤小，并能重建感觉．是修复手指中末节软组织缺损的一种理想方法．
Objective To observe the treatment outcome of using reversed island flap based on cutaneous branch of dorsal metacarpal artery for middle-and-distal finger soft tissue defect. Methods From May, 2015 to March, 2017, 21 cases of middle-and-distal finger soft tissue defect were treated with reversed island flaps based on cutaneous branch of dorsal metacarpal artery which were designed on the dorsal hand pedicled by dorsal metacarpal artery. The flap was then elevated and rotated at the point where digital common artery was anastomosed with the terminal branch of the dorsal metacarpal artery, The cutaneous nerve included in the flap was anastomosed with the terminal branch of digital nerve to restore sensation and the donor site was covered directly. Regular followed-up was performed after operation. Results Except 1 case was suffered with distal 1/3 skin flap necrosis, flaps were well developed. Postoperative follow-up period was 3 to 12 months. All these flaps recovered with satisfying appearance and quality, excellent sensation with grade S3 to S4 and 5 to 8 mm of two-point discrimination. Range of motion（ROM） of the metacarpalphangeal and interphalangeal joint of the injured fingers was good. The excellent and good rate was 95.2%. Conclusion Reversed island flap based on dorsal cutaneous branch of dorsal metacarpal artery transfer is an ideal method for repairing middle-and-distal finger soft tissue defect. The surgery is simple. Reliable blood supply and sensation can be achieved without sacrificing the primary artery and nerve. There is minor donor site damage and very few complications.
作者
王扬剑
陈林海
郑雪红
宋庆华
吴睿
黄斌
魏鹏
Wang Yangjian;Chen Linhai;Zheng Xuehong;Song Qinghua;Wu Rui;Huang Bin;Wei Peng.(Department of Hand ＆ Foot and Microsurgery, Ningbo First Hospital, Ningbo, Zhejiang Province 315010, China)
出处
《中华显微外科杂志》
CSCD
北大核心
2018年第3期213-215,共3页
Chinese Journal of Microsurgery
基金
宁波市科技惠民项目（2017C50064）
关键词
掌背动脉
外科皮瓣
指损伤
显微外科手术
Dorsal metacarpal artery
Surgical flap
Finger injury
Microsurgical operation
作者简介
通信作者：魏鹏，Email：2484328633@qq.com
