游离双叶骨间后动脉皮瓣修复两个手指软组织缺损  

Free bilobed posterior interosseous flaps for two fingers reconstruction

作　　者：李匡文[1] 刘鸣江[1] 刘俊[1] 黄新锋[1] 黄雄杰[1] 伍鹏[1] 

机构地区：[1]南华大学附属南华医院手外科,湖南省衡阳市421002

出　　处：《中华显微外科杂志》2012年第5期378-380,I0005,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨游离双叶骨间后动脉皮瓣修复两个手指软组织缺损的临床应用效果。方法根据相邻两指创面相隔距离的远近，利用骨间后动脉不同区域的皮支组合，设计以骨间背动脉为主干的一蒂双叶皮瓣，修复10例20指皮肤软组织缺损，其中创面分布于拇、示指1例，示、中指2例，中、环指4例，环、小指3例。手指创面面积最小2．5cm×2．0cm，最大9．5cm×3．0cm，皮瓣面积最小3．0cm×2．5cm，最大10．0cm×3．5cm。结果10例19指皮瓣术后顺利存活。1指皮瓣尖端少许坏死，换药后愈合。术后随访6-22个月，平均13．8个月，皮瓣颜色、质地好，8例外形美观，2例较臃肿，8指皮瓣吻合皮神经，两点辨别觉恢复到10—15mm。平均12．8mm。前臂供区的运动功能均无影响。结论游离双叶骨间后动脉皮瓣修复两个手指软组织缺损，可以获得良好的外观与功能，供区损伤小，是一种较好办法。Objective To present the therapeutic effect of the free bilobed posterior interosseous flap for soft tissue reconstruction of two fingers. Methods According to the distance between the defects of two adjacent fingers, combining the cutaneous branches of different regin, the free bilobed flaps pedicded with pos- terior interosseous artery were applied for soft tissue reconstruction of 20 fingers in 10 patients. The defects of digits was on thumb and index （1 case ）, index and middle （2 cases）, middle and ring （4 cases）, ring and little （3 cases）. The size of defect was ranged from 2.5 cm × 2.0 cm to 9.5 cm × 3.0 cm. The size of single flap was from 3.0 cm × 2.5 cm to 10.0 cm × 3.5 cm. Results The flaps on 19 fingers were completely survived and the flap on 1 finger had the pointed end necrosis which healed by dressing changing. After 6 to 22 months （the average was 13.8 months） followed-up visit, all flaps were with excellent colour and texture. The flaps in 8 cases were thin and the flap in 2 case was a little thick. Eight single flaps in which the cutaneous nerve was su- tured recovered 2-PD of 10 to 15 mm （the average was 12.8 mm）. There was no affection in motor function on donor site of all cases. Conclusion The free bilobed posterior interosseous flap is the valuable option for two fingers soft tissue reconstruction and it can achieve the cosmetically and fuctionaly acceptable result with low morbidity on donor site.

关 键 词：骨间后动脉 双叶皮瓣 指 显微外科 

分 类 号：R658.2[医药卫生—外科学]