足背复合皮瓣在手部复合损伤中的应用  

The application of composite dorsalis flap in repair of hand injuries

作　　者：李中国 李秀忠[2] 

机构地区：[1]山东省蒙阴县地矿局第七地质队职工医院,276200 [2]山东淮坊解放军89医院骨科

出　　处：《中国局解手术学杂志》2000年第4期317-318,共2页

摘　　要：目的 介绍用足背复合皮瓣修复手背软组织伴多条指伸肌腱缺损的临床经验。方法 用带趾长伸肌腱和腓浅神经足背内侧(或中间)皮支的足背复合皮瓣,修复手背复合组织缺损15例。足背供区用带真皮下血管网游离皮片覆盖。结果 经过平均4.5年的随访。移植皮瓣全部成活,感觉恢复至S_2～S_3级。患手掌指关节活动度从术前的20°(平均)增加至60°(平均),恢复了部分抓握功能。供区足背外形饱满无凹陷,植皮区耐摩、耐压、行走良好。结论 足部复合皮瓣移植是修复手部复合组织缺损的较好方法。Objective To introduce the clinical experience of using composite dorsalis flap for repair of soft tissue defect of the dorsum of the hand combined with multiple extensor tendon defect. Methods The dorsalis pedis composite flap was used to repair complex tissue defect on dorsum of the hand in 15 cases. The composite flap induded the extensor digitorum longus tendon and the dorso-medial or dorso-middle cutaneous branch of the superficial peroneal nerve. The donor site on dorsum of the foot was covered by free skin graft with subdermal vascular network. Results All the transplanted flaps survived. After 4.5 years follow-up, the sensation of the flap was found to be graded S2-S3.The average range of motion of the metacarpophalangeal joint increaed from 20° preoperatively to 60° postoperatively. Grasp and grab function was restored to some extent. The appearance of the donor foot was normal. Conclusion Dorsalis pedis composite flap transplantation is a good procedure for repair of complex tissue defect of the hand.

关 键 词：外科皮瓣 手外伤 足背复合皮瓣 指伸肌腱缺损 

分 类 号：R653.2[医药卫生—外科学]