掌骨背皮瓣在断指再植中的应用  

Application of metacarpal dorsal flap in the replantation of amputated fingers

作　　者：李守峰[1] 田明波[1] 郭小磊[1] 宋文超[1] 

机构地区：[1]郑州人民医院骨一科,河南郑州450003

出　　处：《实用手外科杂志》2017年第3期291-292,296,共3页Journal of Practical Hand Surgery

摘　　要：目的 探讨掌骨背皮瓣在伴有背侧皮肤缺损中的断指再植术中的应用.方法 2008-2015年,对19例因机器绞伤、碾轧伤、挤伤等伴有背侧皮肤缺损断指进行再植,在不缩短指骨的情况下用携带手背静脉及掌骨背动脉伴行静脉的掌骨背皮瓣重建断指静脉回流并修复缺损创面.结果 19例断指术后18例成活,其中1例出现动脉危象,经探查后好转;1例指体坏死,皮瓣成活;成活指体功能恢复良好.结论 伴有背侧皮肤缺损的断指再植,在不缩短指骨的情况下应用掌骨背动脉皮瓣修复创面及重建指体静脉回流,效果满意,即提高断指成活率,又保留了断指的长度.Objective To study the clinical application efficacy of Metacarpal dorsal flap in repairing the skin defect of replanted amputated fingers. Methods From 2008 to 2015, using Metacarpal dorsal flap with dorsal vein of hand and accompanying vein of dorsal metacarpal artery to reconstruct venous return and repair the dorsal skin defect of amputated fingers which were caused by machine strangulation, mangled injury and crush injury. Results 18 of 19 amputated fingers survived and obtained good functional recovery after anticoagulants, anti-infection and antispasmodic treatments after surgery. Arterial crisis occurred in 1 cases, which wes improved after exploration surgery. Conclusion Metacarpal dorsal flap with dorsal vein of hand and accompanying vein of dorsal metacarpal artery can reconstruct venous return of amputated fingers with dorsal skin defect, which contributes to save the fingers without reducing the length of the finger.

关 键 词：断指再植 指背皮肤缺损 掌骨背皮瓣 

分 类 号：R658.1[医药卫生—外科学]