带神经的异指指动脉顺/逆行岛状皮瓣修复手指掌侧复合软组织缺损的临床比较研究  

Comparative study of antegrade digital artery island flap of different fingers with nerves for repair of palmar composite soft tissue defect

作　　者：马传亮 彭俊才 马建 Ma Chuanliang;Peng Juncai;Ma Jian(Department of Orthopaedics,Second People′s Hospital of Anhui Province,Hefei 230000,China)

机构地区：[1]安徽省第二人民医院骨科,安徽合肥230000

出　　处：《海军医学杂志》2020年第3期287-290,共4页Journal of Navy Medicine

基　　金：安徽省科技攻关项目(1604a0802078)。

摘　　要：目的观察比较带神经的异指指动脉顺行岛状皮瓣与逆行岛状皮瓣修复手指掌侧复合软组织缺损的临床疗效及患者预后情况。方法选择2016年6月至2019年4月期间安徽省第二人民医院骨科收治的58例手指掌侧复合软组织缺损患者,按照其适应证与具体表现确定手术方式,根据手术方式分为2组,接受异指指动脉顺行岛状皮瓣修复治疗的23例患者为顺行组,接受逆行岛状皮瓣修复治疗的35例患者为逆行组。比较2组患者手术治疗情况,并于术后随访6个月追踪观察患者患指功能恢复及并发症发生情况。结果顺行组患者手术时间短于逆行组,两点辨别觉低于对照组,差异均有统计学意义(P<0.05),指间关节活动度组间比较差异无统计学意义(P>0.05);患者均获得有效随访,顺行组功能恢复评分优良率与逆行组比较差异无统计学意义(P>0.05);患者术后并发症发生率2组比较差异无统计学意义(P>0.05)。结论以带神经的异指指动脉顺行岛状皮瓣修复手指掌侧复合软组织缺损,手术操作时间短且更有利于缩短患者两点辨别觉,临床疗效优于逆行岛状皮瓣修复方式。Objective To observe and compare clinical efficacy of antegrade digital artery island flap of different fingers with nerves and retrograde island flap repair for repair of palmar composite soft tissue defect and prediction of prognosis.Methods Fifty-eight patients with palmar composite soft tissue defect admitted into the hospital from June 2016 to April 2019 were enrolled as study subjects.Surgical procedures were determined according to the patient indications and specific performance,and the patients were divided into 2 groups by the way of different surgical procedures.Twenty-three patients with antegrade digital artery island flap of different fingers were designated as the antegrade group,and 35 patients with retrograde island flap repair were assigned as the retrograde group(or the control group).Treatment effects of surgery were compared between the patients of the 2 groups.Six-month medical follow-up after surgery was made to observe postoperative functional recovery of the affected fingers and the rate of complications.Results All the patients had effective medical follow-up.The surgical time of the antegrade group was shorter than that of the retrograde group,and the two-point discrimination in the antegrade group was lower than that of the retrograde group,with statistical significance(P<0.05).There were no statistical differences in the motion of finger joints,when comparisons were made between the 2 groups(P>0.05).There were no differences in excellent scores of functional recovery,when comparisons were made between the 2 groups(P>0.05).Statistical differences could neither be seen in the rate of complications after surgery,when comparisons were made between the 2 groups(P>0.05).Conclusion The surgical time of antegrade digital artery island flap of different fingers with nerves for the repair of palmar composite soft tissue defect was shorter,and the former surgical procedure could help to shorten two-point discrimination,and its clinical efficacy was superior to that of the retrograde island flap

关 键 词：掌侧复合软组织缺损 岛状皮瓣修复 异指 

分 类 号：R68[医药卫生—骨科学]