三种前臂微型游离皮瓣修复手指软组织缺损的比较  

Comparison of three kinds of forearm micro free flaps for soft tissue defect of fingers

作　　者：吴刚[1] 付强[1] 黄一拯 王华松[1] 黄继锋[1] 日：2017-11-17）

机构地区：[1]中国人民解放军武汉总医院骨科,湖北武汉430070

出　　处：《中国矫形外科杂志》2018年第14期1274-1277,共4页Orthopedic Journal of China

摘　　要：[目的]探讨三种用于修复手指软组织缺损的前臂微型游离皮瓣的效果及其差别。[方法]2013年5月～2016年5月收治32例手指软组织缺损患者(42指),其中10例为2指软组织缺损,22例为1指软组织缺损,分别应用桡动脉掌浅支腕横纹皮瓣、尺动脉腕上皮支皮瓣或(和)骨间背侧动脉穿支皮瓣游离移植修复。[结果]术后随访6～12个月,1例骨间背侧动脉穿支皮瓣和2例尺动脉腕上皮支皮瓣术后出现小面积坏死,其余皮瓣均一期成活。2例骨间背侧动脉穿支皮瓣和2例尺动脉腕上皮支皮瓣由于外观和功能影响二期行皮瓣整形术。[结论]应用桡动脉掌浅支腕横纹皮瓣、尺动脉腕上皮支皮瓣和骨间背侧动脉穿支皮瓣游离移植修复手指软组织缺损有其相似的共同点,同时三者之间又有一些微妙的差别,需根据受区具体情况酌情选择为宜。[Objective] To compare clinical outcomes of three kinds of forearm micro free flaps for soft tissue defect of fin- gers and discuss differences among these three flaps. [Methods] From May 2013 to May 2016, 32 patients with soft tissue defect of finger （42 fingers） were enrolled into this study, including 10 patients with 2 fingers involved and 22 with only 1 finger affected. The free flap pedicled with the superficial palmar branch of radial artery from palmar wrist was used in 18 fingers, while that with tile supracarpal cutaneous branch of ulnar artery in 16 fingers, and flap with the dorsal interosseous artery perforator were applied in 8 fingers. [Results] The patients were followed up 6 to12 months. All the flaps survived in first stage except 1 flap pedicled with dorsal interosseous artery perforator and 2 flaps pedicled with supracarpal cutaneous branch of ulnar artery suffered from small area of necrosis. In addition, 2 flaps pedicled with dorsal interosseous artery perforator and 2 flaps pedicled with supracarpal cutaneous branch of ulnar artery underwent secondary surgery of thinning the flaps for their compromised appearance and function. [Conclusion] These three free micro flaps of forearm have some common features but were subtly different in non-obvious ways. Selection of these flaps should base on the concrete conditions.

关 键 词：手指损伤 外科皮瓣 移植 创面修复 

分 类 号：R687[医药卫生—骨科学]