带感觉神经的桡动脉掌浅支腕横纹皮瓣重建手指中远节指腹缺损  

Reconstruction of defects of distal-and-middle segments of finger pulps with striated wrist transverse flap carrying superficial palmar branch of radial artery with sensory nerve

作　　者：牛海州 吴敏[1] 官建中[1] 韩仲兵 刘洋洋 高许斌[1] 张宽宽 NIU Haizhou;WU Min;GUAN Jianzhong;HAN Zhongbing;LIU Yangyang;GAO Xubin;ZHANG Kuankuan(Department of Orthopeadics,The First Affiliaied Hospital of Bengbu Medical College,Bengbu,Anhui Province 233000,China)

机构地区：[1]蚌埠医学院第一附属医院骨科,安徽蚌埠233000

出　　处：《中华显微外科杂志》2022年第1期41-45,共5页Chinese Journal of Microsurgery

基　　金：安徽省高校自然科学研究重点项目(KJ2021A0723)。

摘　　要：目的探讨携带感觉神经的桡动脉掌浅支腕横纹皮瓣游离修复手指中远节指腹缺损的临床疗效.方法收集2019年2月至2021年3月,应用游离桡动脉掌浅支腕横纹皮瓣修复中远节指腹缺损的20例患者病例资料,创面面积为2.0 cm×1.5 cm~4.0 cm×1.5 cm,皮瓣切取面积2.5 cm×2.0 cm~4.5 cm×2.0 cm.20例患者皮瓣均携带正中神经掌皮支重建指腹感觉,供区均直接缝合,术后通过门诊复查和微信同步随访,根据患指皮瓣外形、感觉和功能恢复情况进行评价.结果20例皮瓣全部成活,伤口愈合良好,定期随访了所有患者,随访时间为6~12(平均8)个月,皮瓣颜色与手指皮肤接近,不臃肿,皮瓣质地柔软,外形及功能良好,TPD为6~11 mm,平均8 mm,供区瘢痕隐蔽,手腕功能无影响.手指功能按中华医学会手外科学会上肢功能评定试用标准,优16例,良4例.结论带感觉神经的桡动脉掌浅支腕横纹皮瓣修复重建手指中远节指腹缺损,具有皮瓣质地良好、供区隐蔽、切取方便、术后感觉恢复良好等诸多优点,值得临床推广.Objective To evaluate the clinical effect of striated free wrist transverse flap pedicled with superficial palmar branch of radial artery carrying sensory nerve in repairing pulp defect of middle-and-distal segments of fingers.Methods From February 2019 to March 2021,the data of 20 patients with defects of middle-and-distal finger segment were collected.The defects were repaired with striated free wrist transverse flaps pedicled with superficial palmar branch of radial artery.The defects sized were 2.0 cm×l.5 cm-4.0 cm×1.5 cm,and the flaps sized were 2.5 cm×2.0 cm-4.5 cm×2.0 cm.The flap carried metacarpal cutaneous branch of median nerve for the reconstruction of the sensation of finger pulps.The donor sites were directly sutured.After operation,the patients were evaluated according to the shape,sensation and functional recovery of the repaired fingers through outpatient visits and reviews via WeChat.Results All 20 flaps survived and the wounds healed well.All patients entered regular follow-up for 6-12(average,8)months.The colour of the flaps was close to the finger skin,without bloating flaps.The flaps were soft in good shapes and function.TPD were 6-11 mm,at 8 mm in average.The scars at the donor sites were hidden and the wrist function was not affected.According to the Trial Evaluation Standard of Upper Limb Function of Hand Surgery Society of Chinese Medical Association,16 patients were classified as excellent and 4 as good.Conclusion The striated transverse wrist flap with radial artery palmar superficial branch and sensory nerve offers many advantages,such as a good texture,hidden donor site,convenient flap harvesting,good recovery of sensation,etc.More clinical studies and the promotion of the technique are expected.

关 键 词：桡动脉掌浅支 腕横纹皮瓣 指腹缺损 修复 重建 

分 类 号：R658.2[医药卫生—外科学]