改良趾腓侧动脉皮瓣修复手指指腹缺损的应用  

The Application of Modified Hallux Fibular Artery Flap for Repairing the Finger Pulp Defect

作　　者：吴耿[1] 邓雪峰[1] 邓君[1] 关助明[1] 陈飞强[1] 林利忠[1] 李岩松[1] 钟科明 

机构地区：[1]广东医学院附属龙华新区中心医院创伤骨科,深圳518110

出　　处：《中国现代手术学杂志》2015年第4期301-304,共4页Chinese Journal of Modern Operative Surgery

基　　金：2013年深圳市龙华新区科技计划社会公益项目(项目编号:2013124)

摘　　要：目的探讨改良趾腓侧动脉皮瓣游离移植修复手指指腹缺损的解剖特点和临床应用。方法 2013年3月~2015年3月我科应用改良后趾腓侧动脉游离皮瓣修复手指指腹缺损10例,缺损面积(1.8 cm×1.4 cm)^(2.8 cm×2.0 cm)。在传统的趾腓侧皮瓣设计基础上,整体将皮瓣向近端和趾背移动,使皮瓣位于趾背侧,供血动脉为趾趾底腓侧固有动脉不变,回流静脉为趾背浅静脉。结果本组10例均顺利完成手术,皮瓣大小(2.4 cm×1.8 cm)^(3.4 cm×2.4 cm),皮瓣均成活,无坏死,无静脉回流障碍。10例随访2个月~2年,皮瓣外形满意,皮瓣色泽接近手指,质地弹性良好,两点辨别觉6~8 mm,患指捏持正常,供足行走自如。结论改良趾腓侧动脉皮瓣修复手指指腹缺损,静脉口径更大,解剖更容易,供受区并发症更少,皮瓣改良后降低了手术难度,提高了手术成功率。Objective To explore the anatomical features and clinical application about modified hallux fibular artery flap for repairing finger pulp defect. Methods From March 2013 to March 2015,a total of 10 cases with finger pulp defect were repaired by modified hallux fibular artery flap. The defective area ranged from 1. 8 cm × 1. 4 cm to 2. 8 cm × 2. 0 cm. Based on the traditional design of hallux fibular flap,the modified flap was moved to the proximal and dorsal hallux entirely and located in the dorsal hallux,and the artery of blood supply was hallux fibular intrinsic artery and the reflux vein was dorsal digital superficial vein.Results All flaps were survived in all 10 cases with area of 2. 4 cm × 1. 8 cm to 3. 4 cm × 2. 4 cm. All cases were followed up for 2 months to 2 years. The appearance of the flap was satisfied,the color was near to normal,and the flexibility and texture were good. The two-point discrimination was 6 to 8 mm. The pinching of injury finger and the donor flap of foot were restored. Conclusion The modified hallux fibular artery flap can decrease the surgical difficulty and improve the success rate for repairing finger pulp defect with bigger caliber of veins,easier anatomy and less complications.

关 键 词：外科皮瓣 [足母]趾 指损伤 软组织损伤 显微外科手术 

分 类 号：R658.2[医药卫生—外科学]