应用股前外侧皮瓣修复手背软组织和指伸肌腱缺损  

Anterolateral femoral flap for repairing dorsal hand soft tissue and extensor tendon defect

作　　者：唐继全[1] 甘干达[1] 陶智刚[1] 罗平[1] 扈克治[1] 

机构地区：[1]解放军181医院创伤显微外科,广西桂林541002

出　　处：《创伤外科杂志》2011年第4期324-326,共3页Journal of Traumatic Surgery

摘　　要：目的探讨股前外侧皮瓣修复手背软组织和指伸肌腱缺损的临床应用。方法对17例手背软组织和指伸肌腱缺损患者行急诊清创、负压封闭引流(VSD)覆盖创面,7～10天后应用股前外侧皮瓣移植修复创面,同时将缺损指伸肌腱近、远端分别与阔筋膜编织缝合。Ⅱ期将阔筋膜修成肌腱形状并行手指功能锻炼。结果 17例皮瓣移植术后完全成活,Ⅱ期手术后皮瓣血运良好。有效随访14例,随访时间8～18个月,平均13个月,皮瓣外形满意,按中华医学会手外科学会手部肌腱修复后评定标准[1]评定,优7例,良5例,可1例,差1例;优良率85.7%。结论股前外侧皮瓣是修复手背软组织和指伸肌腱缺损的较好方法。Objective To study the clinical application of the anterolateral femoral flap for repairing dorsal hand soft tissue and extensor tendon defect.Methods Totally 17 patients with dorsal hand soft tissue and extensor tendon defect were performed emergent debridement,wound coverage with VSD,wound repair with anterolateral femoral flap after 7 to 10 days.Meanwhile,the extensor tendon defect of the proximal and distal tendons was sutured with femoral fascia in the Ⅱ period,and finger exercise was performed.Results Flaps in the 17 cases all survived completely,with good blood supply after the Ⅱ period operation.Effective follow-up was achieved in 14 patients,with the followed-up period for 8-18 months（mean 13 months）.Meanwhile,the flap shape was satisfied.According to the evaluation criteria of Chinese Medical Association Society of Hand Surgery for tendon repair of hand showed excellent in 7 cases,good in 5 cases,fair in 1 case and poor in 1 case,with the excellent and good rate of 85.7%.Conclusion The anterolateral femoral flap is a good way to repair the dorsal hand soft tissue and extensor tendon defects.

关 键 词：软组织缺损 皮瓣 手 肌腱 修复术 

分 类 号：R622[医药卫生—整形外科] R685.4[医药卫生—外科学]