严重手指伴手掌部分缺失的修复重建  

Reconstruction of severely mutilated fingers along with partial palm defect

作　　者：刘勇[1] 张成进[1] 付兴茂[1] 王剑利[1] 隋志强[1] 张雪涛[1] 王蕾[1] 

机构地区：[1]解放军第八十九医院全军创伤骨科研究所,潍坊261021

出　　处：《中华手外科杂志》2015年第3期212-214,共3页Chinese Journal of Hand Surgery

摘　　要：目的 探讨应用足趾联合肩胛骨皮瓣进行手指伴手掌部分缺失修复重建的临床效果.方法 切取肩胛骨皮瓣重建缺失手掌,切取双足2至4个足趾进行手指再造,一期完成手的修复重建.2010年6月至2013年3月对8例严重手指伴手掌部分缺失的患者应用该方法进行手的修复重建.结果 8例手修复重建全部存活.其中1例术后第1天发生血管危象,经重新探查吻合血管后存活.术后随访时间为6～12个月,手外形及功能恢复良好,按手指功能损害程度的综合评定,全部手功能由术前的10％上升到术后的60％,功能平均增加50％,极大地改善了手的功能.结论 应用足趾联合肩胛骨皮瓣进行手指伴手掌部分缺失的修复重建是一种较好的方法.Objective To investigate the clinical outcomes of reconstructing fingers and partial palm defect with combined transfer of toes and scapula osteocutaneous flap.Methods The scapula osteocutaneous flap was transferred to reconstruct the missing part of the palm of the hand.Depending on the number of fingers that were missing,2 to 4 toes were harvested from both feet and transferred to reconstruct the fingers simultaneously.From June 2010 to March 2013 a total of 8 cases of severely mutilated hand were reconstructed by this method.Results All the transplants in the 8 cases survived completely.Vascular crisis occurred within the first 12 hours postoperatively in 1 case.Surgical exploration and re-anastomosis of the vessel solved the crisis and led to transplant survival.Postoperative follow-up ranged from 6 to 12 months.Appearance and function of the reconstructed hands were good.Comprehensive evaluation of hand function based on severity of the defects indicated an improvement of whole hand function from 10% to 60%,an average increase of 50%.Conclusion Combined transfer of toes and scapula osteocutaneous flap is a good technique for reconstructing fingers and partial palm defect.

关 键 词：外科皮瓣 移植 组织瓣 手修复重建 

分 类 号：R782.2[医药卫生—口腔医学]