桡动脉掌浅支腕横纹游离皮瓣修复治疗手部创伤的临床效果  

Clinical effect of treatment for hand trauma with free flap of radial artery superficial palmar branch

作　　者：白杰[1] 许玉本[1] 周海振[1] 田钊[1] 邢梅利[1] BAI Jie XU Yu-ben ZHOU Hai-zhen TIAN Zhao XING Mei-li(Department of Hand Surgery, Red Cross Hospital Affiliated to Medical School of Xi＇an Jiaotong University,Shaanxi Xi＇an 71005, China)

机构地区：[1]西安交通大学医学院附属红会医院手外科,陕西西安710054

出　　处：《局解手术学杂志》2017年第6期435-438,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨桡动脉掌浅支腕横纹游离皮瓣修复治疗手部创伤的临床效果。方法回顾性分析2013年1月至2015年12月在我院诊治的100例手部创伤患者的临床资料。所有患者均采用桡动脉掌浅支腕横纹游离皮瓣修复治疗;观察患者术后皮瓣坏死率、存活情况、感染率;所有患者术后均进行6个月的随访,通过X射线检查骨折愈合情况,对手功能恢复情况进行评估。结果 9例患者皮瓣局部坏死,坏死率为9%;10例患者出现局部感染,感染率为10%,经换药以及对症处理后,感染被有效控制,皮瓣均得以存活;81例患者皮瓣轻微肿胀,外观良好,色泽接近于原手指皮肤的颜色。对100例患者随访6个月显示上皮化全部成功;X射线检查显示骨折愈合情况良好;有7例出现钩甲畸形,5例出现指甲再生缓慢。手功能恢复情况:73例优(73%),16例良(16%),11例中(11%)。结论桡动脉掌浅支腕横纹游离皮瓣修复治疗手部创伤皮瓣存活率较高,手功能恢复情况好。Objective To investigate the clinical effect of the treatment for hand trauma with free flap of radial artery superficial palmar branch. Methods Selected 100 cases of patients with hand trauma who were treated in our hospital from January 2013 to December 2015. All the patients were treated with free flap of radial artery superficial palmar branch. The postoperative necrosis rate, survival rate, and infec- tion rate of flap of all the patients were observed. All the patients were followed up for 6 months, and the healing of fracture were evaluated by X-ray examination so as to evaluate the hand function recovery. Results After the treatment, there were 9 cases of flap local necrosis and 10 cases of local infection,and the necrosis rate and infection rate were 9% and 10% respectively. The infection was controlled effectively after the symptomatic treatment and the flaps all survived. The swelling degree of skin flap was slight and the appearance was good. After 6 months of follow-up, the 100 cases all get epithelization completely. The X-ray examination showed that the fracture healing is good, with 7 cases of hook nail deformity and 5 cases of slow nail regeneration. The hand function recovery was excellent in 73 cases （73%） , good in 16 cases （ 16% ） ,and medium in 10 cases （ 10% ）. Conclusion It is an effective treatment for hand trauma with free flap of radial artery superficial palmar branch, as it can receive high flap survival rate and good recovery of hand function.

关 键 词：皮瓣修复 桡动脉掌浅支 手部创伤 临床效果 

分 类 号：R687.2[医药卫生—骨科学] R641[医药卫生—外科学]