第五掌骨背逆行筋膜蒂皮瓣修复小指皮肤缺损  

The repair of soft tissue loss at the little finger with the fifth dorsal metacarpal reversed fascial flap

作　　者：王涛[1] 顾玉东[1] 杨剑云[1] 陈琳[1] 赵新[1] 

机构地区：[1]复旦大学华山医院手外科,上海200040

出　　处：《中华手外科杂志》2002年第3期146-148,共3页Chinese Journal of Hand Surgery

摘　　要：目的　介绍一种修复小指皮肤缺损的新型逆行筋膜皮瓣。方法　 1 998年 6月至 2 0 0 0年 1 2月 ,用第五掌骨背逆行筋膜皮瓣修复小指皮肤缺损 1 2例。该皮瓣以与第五掌骨纵轴线的平行线为轴心线 ,以筋膜为蒂 ,蒂部设在皮瓣的远端。当皮瓣宽度大于 2cm时 ,蒂部筋膜的宽度一般不宜窄于 1 .2cm。皮瓣的切取范围 ,近端可达背侧腕横纹 ,两侧可达轴心线两旁 1 .5～ 2 .0cm。结果　术后 1 2块皮瓣全部成活 ,但小指有不同程度的肿胀 ,手指伸屈受限。术后 6～ 2 2个月随访 ,手指外形、活动度均恢复正常。结论　第五掌骨背逆行筋膜皮瓣设计合理、血供可靠、操作简便、适用于修复小指 。Objective To introduce a new reversed fascial flap for repair of the soft tissue loss at the little finger. Methods From June 1998 to December 2000, 12 cases of the soft tissue loss at the little finger were covered with the flap. The line paralleled with vertical axial line of the fifth metacarpus served as central axis of the flap. The fascia pedicle was designed at the distal point of the flap. When the width of flap was wider than 2cm, the fascial pedicle should not be narrower than 1.2cm in width. The flap should not extend more proximally than the dorsal transverse carpal crease. The medial and lateral border of the flap was limited 1.5 to 2 cm parallel to the central axis. Results The flap all survived. But certain swelling and restricted flexion and extension of the little finger occurred. The appearance and range of motion of the little finger returned to normal at postoperative 6 to 22 months follow up.Conclusions The fifth dorsal metacarpal reversed fascial flap has advantage of reasonable design, reliable blood supply and simple procedure. It is a good strategy for repair of the soft tissue loss at the little finger, particularly at the middle and distal part.

关 键 词：第五掌骨背逆行筋膜蒂皮瓣 修复 指损伤 小脂皮肤缺损 治疗 手术方法 

分 类 号：R658.2[医药卫生—外科学]