骨间后动脉螺旋桨皮瓣修复腕背和手背部创面九例  

Repair of defects in dorsal of wrist and hand with posterior interosseous artery propeller flap: a report of 9 cases

作　　者：何晓清 石岩 杨曦 崔轶 徐月仙 范新宇 王腾 徐永清 HE Xiaoqing;SHI Yan;YANG Xi;CUI Yi;XU Yuexian;FAN Xinyu;WANG Teng;XU Yongqing(Department of Orthopaedic Surgery,The 920 Hospital of Joint Logistic Support Force of PLA,Kunming 650032,China)

机构地区：[1]解放军联勤保障部队第九二〇医院骨科,昆明650032

出　　处：《中华显微外科杂志》2021年第5期500-502,共3页Chinese Journal of Microsurgery

基　　金：云南省创伤骨科临床医学中心(ZX20191001);第九二〇医院内科技计划项目(2019YGB05,2020YGD08)。

摘　　要：目的探讨骨间后动脉螺旋桨皮瓣修复腕背和手背部创面的初步临床疗效。方法自2015年3月至2019年12月,采用骨间后动脉螺旋桨皮瓣修复腕和手背部创面9例,其中手背缺损6例,腕背缺损3例。软组织缺损面积:6 cm×4 cm~3 cm×3 cm;合并掌骨骨折3例,指骨骨折1例,肌腱断裂1例。根据创面大小及形状设计骨间后动脉螺旋桨皮瓣,转移修复软组织缺损创面,皮瓣大小:20 cm×5 cm~12 cm×3 cm,术中记录骨间后动脉螺旋桨皮瓣皮瓣大小并总结手术特点;术后观察皮瓣成活情况和供区、受区并发症,并进行随访。结果9例皮瓣均顺利切取,供区均直接缝合。术后皮瓣完全成活8例,末端部分坏死1例;并发伤口感染1例。术后随访6~31个月,平均14个月,皮瓣质地、外形良好;末次上肢功能(DASH)评分3~18分,平均9.3分;供区轻度瘢痕增生2例,皮瓣边缘轻度瘢痕增生1例。结论骨间后动脉螺旋桨皮瓣可能是一种修复腕背和手背部中、小创面的有效方法。Objective To investigate the preliminary clinical effect of posterior interosseous artery propeller flap in the repair of dorsal of wrist and hand wounds.Methods From March,2015 to December,2019,9 cases of dorsal of wrist and hand wounds were repaired with posterior interosseous artery propeller flap,including 6 cases of dorsal hand defect and 3 cases of dorsal wrist defect.Defect area:6 cm×4 cm-3 cm×3 cm;There were 3 cases of metacarpal fracture,1 case of phalangeal fracture and 1 case of tendon rupture.According to the size and shape of the wound,the posterior interosseous artery propeller flap was designed to transfer and repair the soft tissue defect wound.The size of the flap:20 cm×5 cm-12 cm×3 cm,the size of posterior interosseous artery propeller flap was recorded and the surgical characteristics were summarized;The survival of the flap,donor and recipient complications were observed and followed-up.Results All flaps were cut smoothly and the donor areas were sutured directly.The flap survived completely in 8 cases and partial necrosis in 1 case;One case complicated with wound infection.The follow-up ranged from 6 to 31 months,with an average of 14 months.The texture and shape of the flap were good;The last DASH score was 3-18,with an average of 9.3;There were 2 cases of mild scar hyperplasia in the donor area and 1 case of mild scar hyperplasia at the edge of the flap.Conclusion Posterior interosseous artery propeller flap may be an effective method to repair small and medium-sized wounds of dorsal of wrist and hand.

关 键 词：骨间后动脉 螺旋桨皮瓣 腕部 手 软组织缺损 修复 

分 类 号：R658.2[医药卫生—外科学]