带掌背神经的腕掌背侧逆行岛状皮瓣再造手指的临床应用  

Clinical application of dorsal reconstruct finger by carpometacarpal reversed island flap with dorsal metacarpal nerve

作　　者：黎德规[1] 左中男[1] 李庆生[1] 徐路生[1] 许琪琨[1] 

机构地区：[1]佛山市第一人民医院手足整形外科,广东佛山528000

出　　处：《局解手术学杂志》2007年第2期92-93,共2页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨带掌背神经的腕掌背侧逆行岛状皮瓣再造手指的临床应用效果。方法设计两条相邻掌背动脉及带掌背神经的腕掌背侧逆行岛状皮瓣,利用废弃手指的骨肌腱支架,或游离骨骼移植,再造有感觉的手指。结果再造手指18例,其中3例是手指脱套伤,获得成功,切取皮瓣最大面积达9 cm×8 cm。18例术后随访3个月至2年,术后7周左右再造手指的痛觉恢复,感觉在S3以上者为89%,其两点分辨觉为5～10 mm。术后再造手指外形满意,感觉恢复接近正常,运动功能恢复到可完成日常活动。结论应用带掌背神经的腕掌背侧逆行岛状皮瓣手术简单实用、成活率高、损伤小、术后的手指有感觉且外形较好。objective To investigate the clinical effect of dorsal carpometacarpal reversed island flap with dorsal metacarpal nerve to reconstruct finger. Methods We designed the dorsal reverse carpal and metacarpal island flaps with nerve by using the adjacent two dorsal metacarpal arteries as blood-supply and applied the stand of bone and tendon in waste finger or the free iliac transplantation to reconstruct the every sensory finger. Results Eighten cases were survived, and the skin degloving injuries of the finger in 3 cases. The maxinum of the flap was 9 cm × 8 cm. Patients were followed up 3 months to 2 years, 7 weeks later pain sense of reconstructed finger was recovered. Sensation over S3, amounts to 89% of the digits. Two-point discrimination was 5 - 10 mm. After the operation, the reconstructed finger obtained good appearance, the sensory recovery approach normally. The patients have ability to accomplish daily activities. Conclusion The method has advantages as follow： simple and practical, high survive rate, low impairment, sensible and good appearance.

关 键 词：手指再造 外科皮瓣 移植 显微手术 

分 类 号：R658.1[医药卫生—外科学]