带掌长肌腱的超大静脉皮瓣修复手指掌侧复合组织缺损  

Repair complex tissue defect of the palm of fingers by the super large vein flap with palmaris longus tendon

作　　者：吴海林[1] 巨积辉[1] 刘新益[1] 蒋国栋[1] Wu Hailin;Ju Jihui;Liu Xinyi;Jiang Guodong(Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province 215104, China)

机构地区：[1]苏州大学附属瑞华医院手外科,江苏省苏州市215104

出　　处：《中华显微外科杂志》2018年第3期223-226,共4页Chinese Journal of Microsurgery

基　　金：江苏省自然科学基金（BK20151203）

摘　　要：目的探讨应用带掌长肌腱的超大静脉皮瓣修复手指掌侧复合组织缺损的临床效果。方法自2011年5月至2017年10月．应用带掌长肌腱的超大静脉皮瓣修复手指掌侧复合组织缺损15例15指．男10例10指．女5例5指。年龄19～51岁（平均35．8岁）。受伤原因：机器绞伤12例，挤压伤3例。均为手指掌侧复合组织缺损。其中拇指3例，示指5例，中指2例，环指5例。所有病例均伴有肌腱的缺损，皮肤缺损面积3．5cm-2．0cm～7．5cm-3．5cm，肌腱缺损长度2．0～4．0cm；4例伴有不同程度近、中末节骨折（2例近节指骨骨折，1例中节指骨骨折。1例末节指骨骨折）。15例均为急诊手术，受伤距手术时间为1．5-3．0h，平均2．0h，手术耗时3．0～4．5h，平均3．6h。定期进行随访。结果15例皮瓣全部成活。14例获得6～12个月的随访，平均7个月，1例失访。皮瓣质地柔软．弹性好．无臃肿．肤色接近正常皮肤．手指功能及外形恢复良好。结论带掌长肌腱的超大静脉皮瓣修复手指掌侧复合组织缺损．皮瓣成活后疗效满意，是一种理想的修复方法。Objective To investigate the clinical effect of super large venous flap with palmaris longus tendon for repairing the complex tissue defect of the palm of finger. Methods From May, 2011 to October, 2017, complex tissue defect of the palm of 15 fingers in 15 cases was treated by a super large vein flap with palmaris longus tendon. There were 10 males with 10 fingers and 5 females with 5 fingers. The age was from 19 years to 51 years （average, 35.8 years）. Among these cases, machine injury was in 12 cases and crush injury was in 3 cases. Complex tissue defect of the palm of the finger with tendon defect occurred in all the cases. There were 3 thumbs, 5 index fingers, 3 middle fingers and 5 ring fingers. The area of skin defect was from 3.5 cm×2.0 cm to 7.5 cm×3.5 cm. The length of tendon defect was 2.0-4.0 cm. Phalangeal fractures occurred in 4 cases （ 2 cases of proximal phalanx, 1 of middle phalanx, and 1 of distal phalanx）. All the patients received the operation in one stage. The time between the injury and the operation was 1.5-3.0 h（average, 2.0 h）. The time of the operation was 3.0-4.5 h（average, 3.6 h）. Regular followed-up was performed after operation. Results All flaps survived. Fourteen cases were followed-up for 6 to 12 months（average, 7 months）, and 1 case lost. The skin flap has soft texture, good elasticity, and no bloat. The color of skin flap was close to the normal skin. Sensory recovery reached S2 to S3, and the function and appearance of the finger were well restored. Conclusion The super large vein flap with palmaris longus tendon can be used to repair the complex tissue defect of the palm of fingers. The flap can get a satisfactory effect after surviving. It is an ideal method of repairing this kind of damage.

关 键 词：静脉皮瓣 掌长肌腱 组织缺损 指掌侧 

分 类 号：R658.2[医药卫生—外科学]