第二趾甲背皮瓣与胫侧皮瓣瓦合修复手指中末节脱套伤  

Combined use of dorsal flap based on second toe and tibial flap for repairing the finger distal degloving injury

作　　者：赵强 巨积辉 侯瑞兴 程贺云 王天亮 

机构地区：[1]苏州瑞华医院手外科,江苏省苏州市215128

出　　处：《中华显微外科杂志》2012年第5期387-390,I0007,共5页Chinese Journal of Microsurgery

基　　金：苏州市科技计划项目（SYS201164）,苏州市吴中区高层次人才资助项目（SYS201164）

摘　　要：目的探讨第二趾甲背皮瓣与胫侧皮瓣瓦合修复手指中、末节脱套伤的治疗方法。方法2008年3月至2011年9月，采用游离足第二趾甲背皮瓣瓦合对侧足第二趾胫侧皮瓣修复手指中、末节脱套伤11例11指，并进行了随访。结果术后皮瓣全部成活，经过4—15个月随访，指背侧的趾甲背皮瓣及掌侧的趾胫侧皮瓣无明显萎缩，指腹饱满，指甲生长良好，指体外形良好，指腹感觉恢复满意，2例为S4，5例为S3，3例为S2，1例为S1，全部病例指背均恢复保护性感觉，手指功能正常，足部供区愈合好，无瘢痕增生，行走完全正常。结论游离足第二趾甲背皮瓣瓦合对侧足第二趾胫侧皮瓣是修复手指中、末节脱套伤的一种理想方法。Objective To explore the treatment method with combined dorsal flap based on the sec- ond toe and tibial flap for repairing the finger distal degloving injury. Methods From March 2008 to Septem- ber 2011, our departmentchose treatment with combined use of free dorsal flap based on the second toe and contralateral second toe tibial flap for repairing finger distal degloving injury. The 11 fingers in 11 cases were treated and followed up after surgery. Results The flaps in 11 cases all survived; The donor site with skin grafting successfully healed; The follow-up was 4-15 months, averaged of 6 months. There was not obvious atro- phy for the toe dorsal flaps in the finger back side and toe tibial flaps in the palm side. The finger pulp was full, the nails grew well and the appearance of the fingers was good. There was satisfactory sensory function restora- tion for finger pulp, two cases for $4, five cases for $3, three cases for $2 and 1 case for S,. The protective sen- sation was restored in the finger back for all the cases; the finger function was restored to normal; the foot donor site was healing well without scarring. Walking was completely normal. Conclusion It is an ideal treatment with combined use of free dorsal flap based on the second toe and contralateral second toe tibial flap for repair- ing finger distal.

关 键 词：手指 脱套伤 足 游离皮瓣 显微外科 

分 类 号：R658.2[医药卫生—外科学]