邻指固有动脉顺行岛状皮瓣修复手指中节以远软组织缺损  

Adjacent finger inherent artery anterograde island flap to repair soft tissue defect with exposed bone of lateral the middle segment of finger

作　　者：呼和[1] 丰波[1] 张澜[1] 牛克诚[1] 王永军[1] 徐立静 

机构地区：[1]内蒙古包钢医院手足踝外科,内蒙古包头014010

出　　处：《实用手外科杂志》2016年第3期276-278,共3页Journal of Practical Hand Surgery

摘　　要：目的：探讨采用邻指固有动脉顺行岛状皮瓣修复手指中节以远软组织缺损和伴指固有动脉远侧交通支损伤的临床疗效。方法2009年9月-2014年12月，应用邻指固有动脉顺行岛状皮瓣修复手指中节以远软组织缺损19例19指，伴指固有动脉远侧交通支损伤36例36指。软组织缺损面积：1．0 cm×1．5 cm^1．5 cm×3．0 cm。皮瓣切取面积：1．5 cm×2．0 cm～2．0 cm×3．5 cm。37例均于伤后6~8 h急诊Ⅰ期行修复术，18例均于伤后Ⅰ期行清创及扩创术，待创面干净后限期行邻指固有动脉顺行岛状皮瓣修复术。结果术后皮瓣全部成活良好，随访6~18个月。皮瓣血运良好，外观饱满，皮肤弹性及色素沉着与健侧无明显差异。供区愈合好，无瘢痕挛缩，手指主、被动活动功能恢复满意，耐寒冷。根据手功能TAM法测定：优41指，良8指，可6指，优良率达89．1％。结论应用邻指固有动脉顺行岛状皮瓣修复手指中节以远软组织缺损和伴指固有动脉远侧交通支损伤临床效果良好。Objective To investigate the clinical value of application adjacent finger inherent artery anterograde island flap to repair soft tissue defect with exposed bone of lateral the middle segment of finger or with the distal traffic artery branch injury. Methods From September 2009 to December 2014, 19 cases of lateral the middle segment of finger soft tissue defects with exposed bone, 36 cases of distal finger artery branches traffic Injury. Wounds area was 1.0 cm ×1.5 cm^1.5 cm ×3.0 cm. The flap size was 1.5 cm ×2.0 cm^2.0 cm ×3.5 cm. 37 patients were all repaired in emergency of 6~8 hours after injury, 18 patients had elective surgery after underwent debridement surgery until. Results All flaps survived well, followed-up of 6~18 months. Flap blood supply was good, appearance looked full, and there were no obvious abnormalities with contralateral in elasticity and skin pigmentation. Donor site healed well, no scar contractured, finger active and passive activities had satisfactory functional recovery, resistance to cold. Based on the measurement of hand function TAM： excellent in 41 fingers, good in 8 fingers, general in 6 fingers, excellent rate was 89.1%. Conclusion Application adjacent finger inherent artery anterograde island flap to repairing soft tissue defect with exposed bone of lateral the middle segment of finger or with the distal traffic artery branch injury can get good clinical results.

关 键 词：指固有动脉 外科皮瓣 手指 软组织缺损 

分 类 号：R686.05[医药卫生—骨科学]