趾腓侧游离皮瓣移植修复手指掌侧软组织缺损  

The clinical effect of free flap of the fibular side of the great toe for repairing soft tissue defect on the palmar side of finger

作　　者：黄国英[1] 蔡伟衫 孙大炜[1] 刘晓春[1] HUANG Guoying;CAI Weishan;SUN Dawei(Department of Traumatic Orthopedic,Second People's Hospital of Guangdong Province,Guangzhou,Guangdong,510317,China)

机构地区：[1]广东省第二人民医院创伤骨科,广东广州510317 [2]广东省工人医院,广东广州510700

出　　处：《实用手外科杂志》2022年第2期139-141,共3页Journal of Practical Hand Surgery

基　　金：广东省医学科研基金(项目编号:C2021016)。

摘　　要：目的 探讨趾腓侧游离皮瓣移植修复手指掌侧软组织缺损的临床效果。方法 回顾2019年1月-2020年1月收治的采用趾腓侧皮瓣修复手指掌侧软组织缺损患者15例。结果 15例皮瓣均成活,皮瓣色泽与周围皮肤相似,质地柔软,外形满意。1例术后发生血管危象,急诊行探查手术,术中见吻合血管处血栓形成,去除血栓重新吻合血管,最终皮瓣成活。术后随访,移植皮瓣两点辨别觉4~8 mm,按中华医学会手外科学会上肢部分功能评定试用标准评定,优良率为95%。供区创面愈合良好,术后一期愈合,无破溃,患者步态无异常。结论 趾腓侧皮瓣具有血管解剖位置恒定、操作简单、术后皮瓣美观、感觉良好等优点,是修复手指掌侧皮肤软组织缺损的良好手术方式,值得临床推广应用。Objective To investigate the clinical effect of free flap of the fibular side of the great toe for repairing soft tissue defect on the palmar side of fingers. Methods Fifteen patients with palmar finger soft tissue defect repaired with fibular flap of the great toe were reviewed from January 2019 to January 2020 in our department. Results The skin flaps survived in all 15 cases. The skin flaps were similar in color, soft in texture and satisfactory in appearance. 1 case had postoperative vascular crisis, emergency exploratory surgery was performed. During the operation, thrombosis was found at the anastomotic site, and the thrombosis was removed and the blood vessel was anastomosed again. Finally, the flap survived. In postoperative follow-up,the two-point discrimination of the transplanted flap was 0.4~0.8 cm, and the excellent and good rate was95% according to the trial standard of upper limb function evaluation of Chinese Medical Association Hand Surgery Society. The donor site wound healing was good, had postoperative healing, no ulceration, the patient had no abnormal gait. Conclusion The fibular flap of the thumb has the advantages of constant vessel anatomical position, simple operation, beautiful skin flap and good feeling after operation. It is a good surgical method for repairing the skin and soft tissue defect of the palm of the finger, and is worthy of further popularization and application.

关 键 词：趾腓侧游离皮瓣 手指掌侧软组织缺损 创面修复 

分 类 号：R658.2[医药卫生—外科学]