吻合神经和静脉的第1掌背桡侧动脉皮瓣修复幼儿拇指指端软组织缺损  

Repairing soft tissue defect of thumb tips in infants by using the first dorsal metacarpal radial artery flaps along with anatomosing of nerves and veins

作　　者：古汉南 古小玲 陈瑶 黄少耿 张喆 王洪刚[2] Gu Hannan;Gu Xiaoling;Chen Yao;Huang Shaogeng;Zhang Zhe;Wang Honggang(Department of Hand Surgery,Longgang Orthopaedics Hospital of Shenzhen,Shenzhen,Guangdong Province 518116,China;Department of Hand Microsurgery and Orthopedic Trauma,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]广东省深圳市龙岗区骨科医院手外科,518116 [2]中山大学附属第一医院显微创伤手外科,广州510080

出　　处：《中华显微外科杂志》2019年第2期114-116,共3页Chinese Journal of Microsurgery

基　　金：深圳市科技计划项目(JCYJ20160429104231738);广东省科技计划项目(2016A020215046).

摘　　要：目的探讨应用吻合神经和血管的第1掌背桡侧动脉逆行岛状皮瓣修复幼儿拇指指端软组织缺损的手术方法和临床效果。方法2015年8月-2017年8月,收治外伤致拇指端软组织缺损幼儿21例21指,缺损面积为2.0cm×1.8cm^3.0cm×2.5cm。应用吻合神经、血管的第1掌背桡侧动脉逆行岛状皮瓣修复,术中切取皮瓣面积为2.2cm×2.0cm^3.2cm×2.7cm。术后定期随访。结果术后皮瓣全部成活,创面均I期愈合。随访时间3~18个月,平均7个月。移植皮瓣外形、质地良好,掌指关节及指间关节活动度正常。根据中华医学会手外科学会上肢部分功能评定试用标准,优14例,良5例,可2例。结论应用吻合神经、血管的第1掌背桡侧逆行岛状皮瓣修复幼儿拇指指端软组织缺损,手术操作简便,修复后指腹饱满,外形及感觉恢复良好,是一种较好的修复方法。Objective To investigate the surgical methods and clinical effect of repairing the thumb tip defects in infants by applying the reversed first dorsal metacarpal radial artery island flaps along with anatomosing of nerves and veins.Methods Twenty-one cases with soft tissue defects of thumb tips caused by trauma were admitted from August,2015 to August,2017.The first dorsal metacarpal radial island artery flaps were transplanted reversely to repair the defects along with the anatomosis of nerves and veins.Among all the cases,the range of defect area was 2.0 cm×1.8 cm-3.0 cm×2.5 cm.The area range of the flap harvested during the surgery was 2.2 cm×2.0 cm-3.2 cm×2.7 cm.The regular post-operative followed-up was performed.Results All flaps survival after the surgeries,and the wounds were I-staged healing.All cases were followed-up by 3-18 months,and the average time was 7 months.The appearance and quality of the flaps were good.The range of motion of the metacarpophalangeal joints and interphalangeal joints was normal.According to the Upper Extremity Functional Evaluation Tentative Criteria set up by Hand Surgery Branch of Chinese Medical Association,14 cases were excellent,5 case was good,and 2 cases were fair.Conclusion The surgery of using the first dorsal metacarpal radial reversed island artery flap to repair the de fect of thumb tip in infant,along with the anatomosis of nerve and vein,is a good method in repairing the defects due to its ease of operation,achievement of plump of finger tip and good recovery of appearance and sensation after the surgery.

关 键 词：第1掌背动脉 皮瓣移植 指端缺损 拇指 幼儿 

分 类 号：R726[医药卫生—儿科]