带桡神经浅支的第一掌骨背逆行筋膜皮瓣修复拇指缺损  

Application of the first dorsal metacarpal reverse fasciocutaneous flap with the superficial branch of radial nerve for repair of thumb defect

作　　者：朱卫 徐晓峰 周峰 巨积辉[2] 侯瑞兴[2] Zhu Wei;Xu Xiaofeng;Zhou Feng;Ju Jihui;Hou Ruixing(Department of Hand Surgery,Changshu Zhitang People's Hospital,Jiangsu 215531,China;Department of Hand Surgery,Ruihua Hospital Affiliated to Suzhou University,Suzhou 215104,China)

机构地区：[1]常熟市支塘人民医院手外科,江苏215531 [2]苏州大学附属瑞华医院手外科,苏州215104

出　　处：《中华手外科杂志》2020年第1期41-43,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨带橈神经浅支的第一掌骨背逆行筋膜皮瓣修复拇指缺损的临床治疗效果。方法自2013年1月至2017年6月收治14例拇指缺损患者,采用第一掌骨背探侧缘或尺侧缘,带挠神经浅支的逆行筋膜皮瓣修复术。皮瓣切取面积为2.0 emx1.5 em-4.5 cm x 3.5 cmo 11例供区宜接缝合,3例供区采用全厚皮片植皮覆盖。结果本组14例皮瓣全部I期存活,无血管危象发生,无坏死及感染发生。术后随访6-15个月,患指外形美观,皮瓣质地柔软,肤色与周围组织接近,且皮瓣耐磨性好。术后皮瓣感觉恢复至S3+,两点分辨觉为6~9mm,恢复痛温觉。患者能够使用拇指进行日常工作及生活。结论带橈神经浅支的第一掌骨背逆行筋膜皮瓣修复拇指缺损具有皮瓣设计合理、血供可靠、切取方便、操作简单等优点,是一种修复拇指缺损的理想术式。Objective To investigate the clinical efficacy of the first dorsal metacarpal reverse fasciocutaneous flap with the superficial branch of radial nerve for repair of thumb defect.Methods From January 2013 to June 2017,14 patients with thumb defect were treated using the first dorsal metacarpal reverse fasciocutaneous flap with the superficial branch of radial nerve.The flap area was 2.0 cm><1.5 cm to 4.5 cmx3.5 cm.The donor area was sutured directly in 11 cases and covered with full thickness skin graft in 3 cases.Results All the 14 flaps were survived uneventfully without vascular crisis,necrosis and infection.The patients were follow-up for 6 to 15 months.The appearance of the fingers was aesthetic,the texture was soft,the skin color was close to the surrounding tissue,and the skin flap had good wear resistance.After the operation,the sensation of the flap recovered to S3+with the two-point discrimination being 6 to 9 mm.The sensation of pain and temperature were recovered.Patients can use their thumbs for daily work and life.Conclusion The first dorsal metacarpal reverse fasciocutaneous flap with the superficial branch of radial nerve has the advantages of reasonable flap design,reliable blood supply,convenient cutting and simple operation.It is an ideal operation for repairing thumb defect.

关 键 词：外科皮瓣 治疗结果 拇指缺损 橈神经浅支 

分 类 号：R65[医药卫生—外科学]