管状脐旁皮瓣修复手指末端脱套伤  

The use of tubed paraumbilical flaps in repairing degloving injuries of fingers

作　　者：刘安[1] 李旭晨[1] 曹江龙[1] 赵二波[1] 

机构地区：[1]长治医学院附属和济医院烧伤科,046011

出　　处：《中华损伤与修复杂志（电子版）》2008年第5期45-46,共2页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的总结手指末端脱套伤的治疗经验。方法2004年3月至2007年11月,应用脐旁皮瓣管状成型修复手指末端脱套伤25例(共32指),在行骨折内固定、肌腱吻合的同时用脐旁皮瓣管状成型修复手指末端脱套伤,观察术后皮瓣成活情况,按照AMA指导评分手功能。结果术后32指皮瓣全部成活,其中29指甲级愈合,3指乙级愈合。合并中节指骨骨折5指6周内固定物取出,肌腱腱止点吻合、肌腱移植修复9指,患指外观良好。全部病例随访3个月,手功能恢复满意。结论用管状脐旁皮瓣修复手指末端脱套伤具有操作简便,一次成型,术后易管理,手功能恢复满意的优点。Objective To summarize the experience in the treatment of degloving injuries of fingers. Methods From March 2004 to November 2007,25 cases （32 fingers in all ） of degloving injuries of fingers were treated with tubed paraumbilical flaps. Internal fixation of the fractured phalanges, anastomoses of the impaired tendons, and using tubed praumbilical flaps to repair the degloving injuries were conducted simultaneously. After operation, the skin flap serviving results were observed, and hands function was evaluated according to AMA guidrlines. Results After operations, all the 32-finger flaps survived,29 with grade A healing, 3 with grade B healing. The internal fixation matters in the 5 injured fingers combined with middie-phalanx fracture were removed in 6 weeks. Nine fingers were rapaired by tendon anastomoses at their endings or by transplantation. All looked good. Each case was followed up for 3 months, with satisfying hands function recovery. Conclusions Using tubed paraumbilical flaps to repair degloving injuries of fingers has the advantages as requiring one operation only with easy procedure, easy management after operation, and satisfying hands function recovery.

关 键 词：手指脱套伤 脐旁皮瓣 管状成型 

分 类 号：R658.2[医药卫生—外科学] R622.1[医药卫生—临床医学]