手部皮瓣修复拇指损伤临床应用及疗效分析  

CLINICAL APPLICATION AND ANALYSIS OF EMERGENCY REPAIRING OF THUMB DEGLOVING INJURIES

作　　者：葛建华[1] 张德绸[2] 鲁晓波[1] 尹一然[1] 阳运康[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川泸州646000 [2]泸州医学院附属中医院心脑内科,四川泸州646000

出　　处：《泸州医学院学报》2011年第6期682-684,共3页Journal of Luzhou Medical College

摘　　要：目的：探讨应用以手背第一、二掌背动脉分叶岛状皮瓣修复拇指套脱伤的临床疗效。方法：本院2004年2月至2008年7月收治拇指套脱伤共11例，男7例，女4例，年龄7～44岁，平均23．5±3．6岁；机器绞伤7例，压砸伤4例；拇指皮肤软组织缺损面积：30mm×55mm～50mm×60mm。均采用第一、二掌背动脉分叶岛状皮瓣转移修复拇指创面。结果：本组11例术后均获随访，时间，4～24月（平均9．5月），所有皮瓣及供区植皮全部存活，中华医学会手外评定科标准：优9指，良2指，优良率达100％，拇指皮肤痛触觉存在，指端两点端分辨觉6～11mm（平均8．4mm）。结论：拇指套脱伤采用以第一、二掌背动脉分叶岛状皮瓣修复，具有皮瓣切取方便、术后皮瓣感觉好、拇指功能恢复佳等优点，是一种疗效较好的手术选择。Obiective To discuss the method of emergency repairing of thumb degloving injuries by sublobe island flaps with pedicle of the first and second dorsal metacarpal artery. Methods：11 cases of thumb degloving injuries were admitted from February 2004 to July 2008,7 males and 4 females with an average age of 23.5±3.6 years, （10 to 45 yeas）.7 cases were twisted by the machinery, and 4 cases were crushed. The skin area defected from 30mm×55mm to 50mm×60mm on thumb, all were repaired by sublobe island flaps with pedicle of the first and second dorsal metacarpal artery. Results：It cases were followed up from 4 to 24 months. All flaps and skingrafting of donor site survived. The excellent and good rates of function were 100% （9 excellent cases ,and 2 good cases）, the function was assessed by the hand-surgery evaluating standard of CMS. Two-point discrimination ranged from 6 to 11 mm with an average of 8.4 mm. Conclusion：Sublohe island flap based on pedicle of the first and second metacarpal anery is a good choice for treating degloving injuries of the thumb. The flaps cut conveniently,and the feeling and the function of thumb is very good after operation.

关 键 词：拇指套脱伤 岛状皮瓣 修复 

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