腹部皮瓣联合指骨及甲床回植重建指尖组织缺损  

Reconstruction of fingertip tissue defect by transposition of abdominal flap and replantation of fingernail bed

作　　者：杜志国[1] 宿晓雷[1] 王伟[1] 李霖娜 黄熠东 许鹏成 陈秀英[2] 李世英[1] 赵建勇[1] DU Zhiguo;SU Xiaolei;WANG Wei(Department of Hand Surgery,Cangzhou Hospital of Integrated Traditional Chinese and Western of Hebei Province,Cangzhou,Hebei,061000,China)

机构地区：[1]河北沧州中西医结合医院手外科,河北沧州061000 [2]河北沧州中西医结合医院妇科,河北沧州061000

出　　处：《实用手外科杂志》2019年第4期400-401,404,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨腹部皮瓣联合指骨及甲床回植重建指尖组织缺损的方法及临床效果。方法 2016年5月-2018年10月,收治10例指尖离断伤患者,术中保留断指指骨及甲床甲皱襞,原位回植,腹部皮瓣包绕覆盖。结果术后10例皮瓣及甲床全部成活。随访时间6~10个月。皮瓣质地、色泽良好,按英国医学研究会评定标准(1954),感觉恢复至S3~S3+。X线片示末节指骨均愈合,愈合时间为12~24周。指体无短缩,各关节活动无影响,甲床生长良好,指甲平整。结论腹部皮瓣联合指骨及甲床回植重建指尖组织缺损的方法,使不能再植的离断指端手指长度及甲床外形得以保留。本手术方法操作简单、安全,适合在基层医院推广。Objective To explore the method and clinical effect of transposition of abdominal flap and replantation of fingernail bed to reconstruct of fingertip tissue defect. Methods From May 2016 to October 2018, 10 cases of fingertips oblique line break. All of plan is the root of the nail bed. After 2-8 hours, during the operation, the severed phalanges and nail folds were preserved, replanted in situ and covered with abdominal flap. Results All the abdominal flaps with vascular plexus survived. Follow up was performed for 6-10 months. The texture and color of flaps were good.According to the British Medical Research Association evaluation standard(1954), sensory recovery reached S3 to S4. In addition,the bone union was obtained in all cases after 12 to 24 weeks. Conclusion The fingertip tissue defect can be reconstructed by transposition of abdominal flap and replantation of nail bed, so that the length of severed finger and nail bed could be preserved for the fingertip amputation without replantation condition. This technology is simple and safe, therefore suitable for popularization in basic-level hospitals.

关 键 词：外科皮瓣 手指损伤 指尖离断伤 

分 类 号：R658.2[医药卫生—外科学]