指端侧方局部转移皮瓣修复指端缺损的临床应用  

The finger lateral local flaps to repair clinical application of finger tip defect

作　　者：闫军锋 胡庆威 付春林 靳兆印 

机构地区：[1]江苏省溧阳市茶亭医院手足外科,江苏省溧阳市213300 [2]常州解放军第102医院骨二科

出　　处：《中华显微外科杂志》2017年第3期241-243,共3页Chinese Journal of Microsurgery

摘　　要：目的探讨应用指端侧方局部转移皮瓣修复指端缺损的临床疗效及优势。方法自2013年8月至2015年12月，采用指端侧方局部转移皮瓣修复第1～4指指端缺损32例32指．其中男20例．女12例。指别：拇指11指，示指9指，中指8指，环指4指。指端缺损面积为0．5cm×0．8cm～1．0cm×1．5cm，均有骨外露，均伴有不同程度的甲床缺损，23例指骨末端部分缺损。致伤原因：碾压伤13例，冲床扎伤11例。利器切割伤8例．伤后至就诊时间为0．5～3．0h，均无合并伤。术后定期随访。结果32例皮瓣全部成活，随访3～24个月．平均6个月。3个月后皮瓣较正常皮肤略显臃肿，皮瓣供区及蒂部瘢痕无挛缩．两点分辨觉为4～5mm．远指间关节屈曲正常。结论指端侧方局部转移皮瓣修复指端缺损，供区瘢痕少，皮瓣不臃肿．外观满意，手术操作简单，功能良好．是修复手指指端缺损比较理想的方法．Objective To discuss the clinical influence and advantages of applying the local flap of finger tip lateral skin to repair the fingertip defective injuries. Methods From August, 2013 to December, 2015, used the way of local the flap of finger tip lateral skin to repair the first-fourth fingertip defects for 32 cases and 32 fingers, among which there were 20 males and 12 females; finger categories： 11 thumbs, 9 index fingers,8 middle fingers and 4 ring fingers. The defective area of fingertips was 0.5 cm×0.8 cm-1.0 cm×1.5 cm, all with bone exposure, 23 cases had defects at the end part of phalanx, 32 cases had different extent of nail bed defects. Reasons for the injuries： 13 cases of grind injuries, 11 cases of punch pressing injuries, 8 cases of sharp tool cutting injuries. The time from injury to the treatment was 0.5-3.0 h, all of them had no associated injuries. Results Thirty-two cases of finger flaps all survived, with the follow-up for 3-24 months and average follow-up of 6 months,the flaps were slightly bloated after 3 months comparing with the normal skin,there was no contracture in the flap area and pedicle scars, two-point discrimination was 4-Smm, the farinterphalangeal joint flexion was normal. Conclusion The local flap of fingertip lateral skin can repair the defects of fingertip with less scar, not bloated flap, satisfying appearance, operation is simple, and good function, so it＇s the ideal way to repair the defects of fingertip.

关 键 词：指端缺损伤 外科皮瓣 局部转移皮瓣 显微外科技术 

分 类 号：R658.2[医药卫生—外科学]