游离踇趾腓侧皮瓣修复手指指腹缺损  

Application of fibula side flap of great toe in the repairment of finger pulp defects

作　　者：崔留超 阮圣幸 陈捷 CUI Liuchao RUAN Shengxing CHEN Jie(Chongqing Greatwall Hospital, the Surgical Department of Extremities, Chongqing 40041, China)

机构地区：[1]重庆长城医院手足外科,重庆40041

出　　处：《实用手外科杂志》2017年第2期212-213,232,共3页Journal of Practical Hand Surgery

摘　　要：目的 探讨应用游离踇趾腓侧皮瓣修复手指指腹缺损的临床应用方法和效果.方法 2015年1月-12月,对20例手指指腹创面,采用游离踇趾腓侧皮瓣修复,供区直接缝合或游离植皮或采用第1跖背动脉逆行岛状皮瓣修复.结果 20例皮瓣全部顺利成活,供区创面经直接缝合、皮瓣修复或植皮后全部成活.术后随访6个月,皮瓣色泽、质地良好,指腹外形饱满,有指纹,两点辨别觉达到5-10 mm.手指屈伸功能恢复良好,按中华医学会手外科学会手功能评定标准,优15例,良5例.结论 踇趾腓侧皮瓣部位隐蔽,皮质和外形与手指指腹最接近,皮瓣趾固有神经与手指固有神经接合后,感觉恢复好,踇趾腓侧趾底固有动脉恒定,血供可靠,手术操作简单,手术时间短,成活率高,外形及感觉恢复佳.游离踇趾腓侧皮瓣是修复手指指腹缺损的理想方法.Objective To study the clinical methods and effects of fibula side flap of great toe in the repair of finger pulp defects. Methods 20 cases of finger pulp defects were repaired by using the free fibular flap of great toe, The skin flap donor areas were sutured directly repaired by skin grafts or repaired by the first dorsal metatarsal artery island flap transplantation. Results All the 20 cases of flaps survived completely , and the wound on donor area all survived after stitching up or skin flaps repairing or skin grafting. within a 6 month＇s follow-up, The flap color, texture, elasticity were good, the finger has a plump appearance of clear fingerprint, and a two-point discrimination abliity of 5-10mm. Finger flexion and extension function recovered well, according to the Chinese Medical Society of Hand Surgery hand function evaluation standard, excellent in 15 cases, good in 5 cases. Conclusion The great toe fibular flap is a hidden-area flap, is most similar to the cortex and the appearance of the finger pulp, after the neurorrhaphy of plantar digital flap and the proper nerve of the finger, the sensory recovery is well, which shows the advantages of constant fibular bottom proper artery of great toe, reliable blood supply, simple operation, short surgical time, high survival rate and excellent rate of shape and sensory recovery. Great toe fibular free skin flap is an ideal method of repairing finger pulp defect.

关 键 词：手指指腹缺损 踇趾腓侧 皮瓣 游离 

分 类 号：R658.2[医药卫生—外科学]