带蒂骨间背侧动脉皮瓣修复复杂手部软组织缺损的临床疗效  

Application of dorsal interosseous artery pedicled flap for repair of complex hand soft tissue defects

作　　者：鲍丙波 钟万润 魏海峰 宋家林[1] 柴益民[1] 张长青[1] 郑宪友[1] Bao Bingbo;Zhong Wanrun;Wei Haifeng;Song Jialin;Chai Yimin;Zhang Changqing;Zheng Xianyou(Department of Orthopedic Surgery,the Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《中华手外科杂志》2022年第4期281-284,共4页Chinese Journal of Hand Surgery

摘　　要：目的探讨带蒂骨间背侧动脉皮瓣修复复杂手部软组织缺损的临床疗效。方法自2018年8月至2020年12月,我们共收治19例复杂手部软组织缺损患者,创面均采用带蒂骨间背侧动脉皮瓣修复,供区一期缝合或植皮。末次随访观察皮瓣外观与色泽,采用中华医学会手外科学会上肢部分功能评定试用标准评定手功能恢复情况,采用英国医学研究会(British medical research council,BMRC)制定的感觉功能评定标准评定皮瓣感觉恢复情况。结果术后19例患者均获得随访,时间为10~18个月,平均16.4个月。19例皮瓣均完全存活,皮瓣及供区均Ⅰ期愈合,皮瓣质地柔软,无色素沉着,外观满意。根据BMRC感觉功能评定标准评定感觉功能:S_(1)1例,S_(2)7例,S_(3)11例。根据中华医学会手外科学会上肢部分功能评定试用标准评定手功能:优6例,良10例,可3例。结论带蒂骨间背侧动脉皮瓣可有效覆盖复杂手部创面,同时可有效恢复手运动及感觉功能,是一种安全可靠的治疗方法。Objective To investigate the clinical efficacy of dorsal interosseous artery pedicled flap for repair of complex hand soft tissue defects.MethodsFrom August 2018 to December 2020,19 patients with complex hand soft tissue defects were treated by dorsal interosseous artery pedicled flap.The donor area was repaired by suturing or skin grafting.In the last follow-up,the appearance and color of the flap were observed.The recovery of hand function was evaluated by the trial standard of upper limb function evaluation issued by Hand Surgery Society of Chinese Medical Association,and the sensory recovery of the flap was evaluated by the sensory function evaluation standard formulated by the British Medical Research Council(BMRC).Results All the 19 patients were follow-up for 10 to 18 months,with an average of 16.4 months.All the flaps survived completely,and the flaps and donor areas achieved primary healing.The flaps had soft texture,no pigmentation and satisfactory appearance。According to BMRC sensory function evaluation standard,the sensory function was evaluated as S_(1)in 1 case,S_(2)in 7 cases and S_(3)in 11 cases.According to the trial standard of upper limb function evaluation of Hand Surgery Society of Chinese Medical Association,the hand function was evaluated as excellent in 6 cases,good in 10 cases and fair in 3 cases.Conclusion,The dorsal interosseous artery pedicled flap can effectively cover the complex hand wounds and restore the hand motor and sensory function.It is a safe and reliable treatment method.

关 键 词：手损伤 外科皮瓣 骨间背侧动脉 修复策略 

分 类 号：R658.2[医药卫生—外科学]