同蒂趾背甲皮瓣、趾侧方皮瓣修复拇手指末节缺损  

Combined Use of the toe Dorsal nail - skin Flap and toe Tibial Flap Based on one Pedicle for Repairing the Defects of Thumb and Finger at the Distal Phalangeal Level

作　　者：李雷[1] 巨积辉[1] 崔龙杰[1] 许华龙[1] 吴海林[1] 

机构地区：[1]苏州大学附属瑞华医院,江苏苏州215000

出　　处：《中国伤残医学》2015年第23期5-9,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨同蒂趾背甲皮瓣、趾侧方皮瓣在修复拇手指末节缺损中应用及疗效。方法：对12例拇手指末节缺损患者，应用吻合血管的同蒂趾背甲皮瓣、趾侧方皮瓣方法修复，趾背甲皮瓣及趾侧方皮瓣供区均采用游离植皮。结果：12例12指，趾背甲皮瓣及侧方皮瓣均成活，手部创面均1期愈合，1例甲皮瓣供区植皮部分坏死，经换药后愈合，所有病例经6个月-36个月随访，平均13个月，游离组织成活良好，指甲生长良好，指腹两点辨别觉恢复6～8mm，足部供区植皮无破溃，足部功能无影响。结论：采用同蒂趾背甲皮瓣、趾侧方皮瓣修复拇手指末节缺损是一种较好的临床方法，功能效果恢复满意。Objective： To explore the clinical applications and outcomes of using the toe dorsal nail - skin flap and toe tibial flap based on one pedicle for repairing the defects of thumb and finger at the distal phalangeal level. Methods： Twlve fingers in 12 cases suffered from defect injury at the distal phalangeal level were reconstructed with the combined dorsal nail - skin flap and tibial flap based on one pedicle. The donor sites of the dorsal nail - skin flap and tibial flap were covered by full - thickness flap. Results： All second toe tibial flaps and hal- lux toe dorsal nail -skin flaps survived. The hand wounds healed well in one stage. The partial skin on the donor site of hallux toe dorsal nail - skin flap is necrosis in one case, and healed well finally through dressing. Patients were followed from 6 months to 36 months with an average of 13 months. All the free tissues survived. Appearance of the nail was satisfactory without deformity. 2 - PD of the finger pulp was from 6mm to 8mm. The donor sites of the flaps healed well without ulcer formation, and all the patients walled well. Conclusion： The hallux toe dorsal nail - skin flap combined with second toe tibial flap based on one pediele is a valuable alternative for the reconstruction of the de- fects of thumb and finger at the distal phalangeal level with satisfactory results both functionally and cosmetically.

关 键 词：甲皮瓣 皮瓣 缺损伤 功能 

分 类 号：R658.1[医药卫生—外科学]