桡动脉鼻烟窝穿支蒂前臂皮瓣修复手部软组织缺损  

Reconstruction of defects on the hand with flaps based on the perforator located at the snuff box

作　　者：张发惠[1] 张朝春[1] 林松庆[1] 宋一平[2] 郑和平[1] 

机构地区：[1]南京军区福州总医院军区骨科研究所,福州350025 [2]解放军第97医院军区创伤骨科中心,江苏徐州221004

出　　处：《中国临床解剖学杂志》2015年第2期223-225,共3页Chinese Journal of Clinical Anatomy

基　　金：福建省自然科学基金(C0510034)

摘　　要：目的探讨桡动脉鼻烟窝穿支前臂外侧皮-头静脉神经营养血管远端蒂皮瓣临床应用效果。方法在前臂远端动脉穿支解剖学研究的基础上,2005年3月至2013年3月间临床采用虎口动脉穿支蒂前臂皮瓣修复手部创伤性软组织缺损27例,致伤原因:机器致伤15例,车祸致伤8例,爆炸伤4例。缺损部位:手背软组织缺损13例;手掌软组织缺损3例;虎口区挛缩11例。软组织缺损面积5.0 cm×3.0cm^12.0 cm×4.0 cm。皮瓣切取面积:最小为6.0 cm×4.0 cm,最大为14.0 cm×6.0 cm,皮瓣旋转点平桡腕关节。结果临床修复27例,创面Ⅰ期愈合26例,Ⅱ期愈合1例。所有病例经2~12个月随访,皮瓣色泽正常,手外形与功能改善满意,前臂供区创面植皮愈合良好,对功能无不良影响。结论桡动脉鼻烟窝穿支蒂前臂皮瓣,可以修复手部远侧创面,效果好。Objective The aim of this study is to investigate the clinical results of flaps based on the perforator located at the snuff box to cover soft tissue defects on the hand. Methods Between March 2005 and March 2013, based on the anatomic study of distal arterial perforators of forearm, 27 patients with softtissue defects on the hand underwent reconstruction with the flaps based on the perforator located at the snuff box The etiology of injury： 15 cases were caused by machines, eight by traffic accident, 4 by explosion. The defect location was as follows： 13 at the dorsal hand, 3 at the palm, 11 at the first web. The defect size ranged from 5.0 cm × 3.0 cm to 12.0 cm × 4.0 cm. The smallest dimension of the flaps was 6.0 cm × 4.0 cm and the largest 14.0 cm×6.0 cm. The rotation point was at the wrist joint level. Results 26 cases of total 27 clinical application cases achieved primary healing; only one case obtained secondary healing. Postoperative following-up of the patients ranged from 2 to 12 months. all flaps survived completely with good color and the appearance and function were satisfactory. The donor site healed without morbidity after reconstruction with skin- grafting. Conclusion t The flap based on the perforator located at the snuff box is an ideal flap for repairing soft tissue defects of distal segment of hands.

关 键 词：前臂外侧皮神经 头静脉 桡动脉鼻烟窝穿支 远端蒂皮瓣 

分 类 号：R323.71[医药卫生—人体解剖和组织胚胎学]