桡动脉掌浅支蒂的腕掌侧嵌合骨皮瓣带蒂转移修复拇指复合组织缺损  

Repair of Thumb Complex Tissue Defect with Carpometacarpal Chimera Bone Skin Flap Pedicle Transfer with Superficial Palmar Branch of Radial Artery

作　　者：李军伟[1] 董帅 李海乐 LI Jun-wei;DONG Shuai;LI Hai-le(Department of Traumatic Orthopedics,Luohe Central Hospital,Henan Province,462000,China)

机构地区：[1]漯河市中心医院创烧骨科,河南漯河462000

出　　处：《中国医疗美容》2020年第3期29-32,共4页China Medical Cosmetology

摘　　要：目的探讨桡动脉掌浅支蒂的腕掌侧嵌合骨皮瓣带蒂转移修复拇指复合组织缺损的效果.方法回顾分析我院2017年2月至2019年4月期间收治的拇指复合组织缺损修复患者30例,均接受桡动脉掌浅支蒂的腕掌侧嵌合骨皮瓣带蒂转移修复,随访患者6个月,分析治疗结果.结果本研究30例患者皮瓣均成活,未出现切口开裂、皮瓣坏死、血运障碍等状况,均接受6-10个月随访,平均为(8.3±1.1)月.术后5周左右,均拔除克氏针,骨折线模糊,术后1.8个月时,骨折线消失,骨折愈合.术后6个月时,患指皮瓣辨别觉为(7.2±1.8)mm,腕关节可正常屈伸,仅1例患者腕横纹部位存在轻微线状瘢痕,各患者均未出现骨折移位、骨坏死、骨髓炎、皮瓣坏死、伤口感染、关节僵硬、功能障碍、瘢痕挛缩等.结论临床治疗拇指复合组织缺损,采用桡动脉掌浅支蒂的腕掌侧嵌合骨片带蒂转移方式,此方式操作简单,可满足组织恢复所需供血,愈合速度快,且供区瘢痕较为隐蔽.Objective To investigate the effect of repair of thumb complex tissue defect with carpometacarpal chimera bone skin flap pedicle transfer with superficial palmar branch of radial artery.Methods A retrospective analysis of 30 cases of thumb complex tissue defect repair admitted in our hospital from February 2017 to April 2019 was carried out.All patients received repair of thumb complex tissue defect with carpometacarpal chimera bone skin flap pedicle transfer with superficial palmar branch of radial artery.The patients were followed up for 6 months and the treatment results were analyzed.Results The skin flaps of all 30 patients in this study survived without incision dehiscence,skin flap necrosis,and impaired blood flow and so on.All patients were followed up for 6-10 months,with an average of(8.3±1.1)months.About 5 weeks after operation,all Kirschner wires were removed and the bone fracture line was blurred.At 1.8 months after operation,the bone fracture line disappeared and the boen fracture healed.At 6 months after operation,the discrimination of the affected finger flap was(7.2±1.8)mm,and the wrist joint could be flexed and extended normally.Only 1 patient had a slight linear scar at the transverse line of the wrist,and no bone fracture displacement,osteonecrosis,osteomyelitis,flap necrosis,wound infection,joint stiffness,dysfunction,scar contracture,etc.occurred in each patient.Conclusion In the clinical treatment of thumb complex tissue defect the method of carpometacarpal chimera bone skin flap pedicle transfer with superficial palmar branch of radial artery is simple,which can meet the needs of tissue recovery,fast healing,and the scar in the donor area is relatively hidden.

关 键 词：拇指复合组织缺损 桡动脉掌浅支蒂 腕掌侧嵌合骨皮瓣带蒂转移 修复 

分 类 号：R658.2[医药卫生—外科学]