拇指区软组织缺损的急诊科即期修复  

The instant repair of the defect of parenchyma in pollex in emergency department

作　　者：彭军[1] 肖蓉[2] 何小梅[1] 

机构地区：[1]成都四川省肿瘤医院急诊科,成都610041 [2]成都四川省肿瘤医院头颅外科,成都610041

出　　处：《中华急诊医学杂志》2007年第4期421-423,共3页Chinese Journal of Emergency Medicine

摘　　要：目的探讨拇指区软组织缺损的急诊科即期（Ⅰ期）修复的解剖分区、适应证和手术方法。方法2000年8月至2006年3月在急诊科即期修复的拇指区软组织缺损病例79例,对缺损进行相应解剖分区和采用适宜修复方法,其中中厚皮片18例,全厚皮片27例,拇指掌侧滑行推进皮瓣修复5例,示指和第二掌骨桡背侧带蒂旋转皮瓣修复11例,示指固有伸肌腱移位、拇长伸肌腱重建术并第二掌骨桡背侧带蒂旋转皮瓣修复5例,甲床修补术并骨折复位和内固定13例。结果Ⅰb、Ⅱ、Ⅰfm和Ⅱfm区域所植皮片或（和）带蒂皮瓣修复者均成活,Ⅰa区3例坏死皮片二期行示指背带血管、神经蒂的岛状皮瓣修复成功。结论掌握骨科矫形或整形外科技术在急诊手外伤治疗中的应用,使之达到即期修复和最大程度保留拇指功能,降低费用和住院时间,拓展和提高急诊医学专业医疗水平和临床实践技能的作用。Objective To evaluate of the division in anatomy, major principles and techniques of operative treatment on the instant repair of the defect of parenchyma in pollex in emergency department. Method Classified by the division in anatomy of the defect of parenchyma in their pollices, 79 patients were repaired instantly in emergency department . These operative treatments were done subsequently： 18 cases by medium - thickness skin graft , 27 cases by full - thickness skin graft , 5 cases by advance skin flap of the palmar pellex, 11 cases by radiodorsal pediele rotation skin flap of the forefinger and second metacarpus, 5 cases by reconstructed the extensor pollieis longus tendon with the extensor indicis tendon of forefinger and radiodorsal pedicle rotation skin flap of the second metacarpus, 13 cases by repair of the bed in fingernails after reduction and internal fixation of distal phalanges. Results At the division of Ⅰ b, Ⅱ , Ⅰ fm and Ⅱ fm , all the skin grafts or skin flaps are survived . The division of Ⅰ a （3 cases in this paper ） were repaired secondly by island skin flaps with the dorsal nettrovascular pediele of forefinger. Conclusions Instant repair of the defect of parenchyma in pollex in emergency department have these effectiveness, such as the instant repair , reservations function of pollex in maximum, reduced Costs and times in patients, expanding and improving the level of medical practice and clinical skills in Emergency Medicine.

关 键 词：拇指区软组织缺损 即期修复 技能 

分 类 号：R686[医药卫生—骨科学]