游离第1跖背动脉骨皮瓣修复手指近节软组织并骨缺损的临床疗效  

Clinical effect of free first metatarsal dorsal artery osteocutaneous flap on repairing proximal segment soft tissue and bone defect of finger

作　　者：吕永源 赵胡瑞 李鸿斌 王绍方 LV Yongyuan;ZHAO Hurui;LI Hongbin(Department of Hand and Foot Microsurgery,The Third People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang,830091,China)

机构地区：[1]新疆维吾尔自治区第三人民医院手足显微外科,新疆维吾尔自治区乌鲁木齐830091

出　　处：《实用手外科杂志》2021年第3期289-292,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨游离第1跖背动脉骨皮瓣修复手指近节软组织并骨缺损的临床疗效。方法 2017年6月-2019年7月采用游离第1跖背动脉的骨皮瓣移植修复手指近节软组织合并骨缺损7例,软组织缺损面积:1.2 cm×1.6 cm~2.2 cm×4.5 cm,骨缺损:2.0 cm×1.0 cm~2.5 cm×1.0 cm。供区皮瓣切取面积大于受区缺损面积0.5 cm,骨皮瓣切取大小与受区缺损面积相同。结果移植骨皮瓣均成活,皮瓣质地软外形良好,足部供区愈合良好,骨皮瓣愈合时间2.0~3.5个月,平均2.2个月。根据中华医学会上肢部分功能评定试用标准评定:优6指,良1指。结论游离第1跖背动脉的骨皮瓣修复手指骨及皮肤软组织缺损是一种较好的方法,植骨成活率高,可同时移植修复肌腱、神经动脉缺损,供区隐蔽、损伤小,可最大限度恢复手指形态和功能。Objective To investigate the clinical effect of osteocutaneous flap with free first metatarsal dorsal artery on repairing proximal finger soft tissue combined with bone defect.Methods From June 2017 to July 2019,7 cases of proximal finger soft tissue with bone defect were repaired by bone flap grafting pedicled with free first metatarsal dorsal artery.The soft tissue defect area was about 1.2 cm×1.6 cm~2.2 cm×4.5 cm,and the bone defect was about 2.0 cm×1.0 cm~2.5 cm×1.0 cm.The flap area of the donor area was 0.5cm larger than the defect area of the recipient area,and the bone flap size was the same as the defect area of the recipient area.Results All the grafted bone and skin flaps survived.The skin flaps were soft in texture and good in shape.The healing time of the bone flaps was 2.0-3.5 months,with an average of 2.2 months.According to the Chinese medical association upper extremity part function evaluation trial standard evaluation:excellent in 6 cases,good in 1 case.Conclusion The free osteocutaneous flap of the first dorsal metatarsal artery is a good method for repairing finger bone and skin soft tissue defects.The survival rate of bone grafting is high.The tendon and nerve artery defects can be repaired by grafting at the same time.

关 键 词：第1跖背动脉 复合组织瓣 手指近节软组织 骨缺损 

分 类 号：R658.2[医药卫生—外科学]