保留皮神经游离腕横纹皮瓣修复手指C形软组织缺损的手术方法及临床效果研究  

Surgical method and clinical effect of free transverse wrist crease flap with preserved cutaneous nerve on repairing finger C-shape soft tissue defect

作　　者：黄成校[1] 高超[1] 丁非凡 HUANG Chengxiao;GAO Chao;DING Feifan(Department of Orthopaedics,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Hubei,Shiyan 442008,China)

机构地区：[1]湖北医药学院附属国药东风总医院骨科,十堰442008

出　　处：《临床外科杂志》2023年第7期670-672,共3页Journal of Clinical Surgery

摘　　要：目的探讨保留皮神经游离腕横纹皮瓣修复手指C形软组织缺损的手术方法及临床效果。方法2019年3月~2021年1月我科收治手指C形软组织缺损病人6例,采用保留皮神经游离腕横纹皮瓣进行修复,皮瓣切取面积为1.8 cm×2.6 cm~3.5 cm×4.8 cm,供区创面直接缝合,应用桡神经掌浅支修复指掌侧固有神经缺损,观察受区及供区术后恢复情况。结果术后6例皮瓣全部存活,皮瓣供区及创面一期愈合,无肌肉粘贴,未存在血管危象。所有病人均获随访术后随访6~12个月,平均8个月。病人皮瓣色泽正常,无明显色素沉着,质地较为柔软,外观良好,保护性感觉恢复。腕部供区仅留有一线性瘢痕,腕关节功能未受到影响。患指感觉功能恢复,指体无萎缩,指关节屈、伸功能恢复正常,活动自如。优4例,良1例,可1例。结论保留皮神经游离腕横纹皮瓣修复手指C形软组织缺损的方法较为理想,皮瓣设计、切取灵活简便,利于手指C形软组织受损部位血运重建及感觉功能恢复。Objective To explore the surgical method and clinical effect of repairing the finger C-shape soft tissue defect by free transverse wrist crease flap with preserved cutaneous nerve.Methods 6 patients with finger C-shape soft tissue defect were repaired with free transverse wrist crease flap with preserved cutaneous nerve in the department between March 2019 and January 2021.The skin flap was cut with an area of 1.8cm×2.6cm-3.5cm×4.8cm,and the donor site wound was directly sutured.The defect of palmar digital nerve was repaired by superficial palmar branch of radial nerve and the postoperative recovery status of recipient site and donor site were observed.Results All flaps survived in 6 cases after surgery,and the donor site of the flap and the wound healed in primary stage without muscle adhesion and vascular crisis.All patients were followed up for 6 to 12 months,with an average of 8 months.Follow-up showed that the skin flaps of patients were with normal color,no obvious pigmentation,soft texture,good appearance and protective sensory recovery.There was only a linear scar left in the wrist donor site,and the wrist function was not affected.The sensory function of the affected finger recovered,the finger body was not atrophied,the flexion and extension function of the finger joint returned to normal,and the activity was free.According to the trial standard of upper limb function evaluation of Chinese Medical Association,there were 4 excellent cases,1 good case and 1 fair case.Conclusion Free transverse wrist crease flap with preserved cutaneous nerve is an ideal method on repairing finger C-shape soft tissue defect,and its design and incision of the flap are flexible and simple,which is beneficial to the revascularization and sensory function recovery of finger C-shape soft tissue defect site.

关 键 词：皮神经 腕横纹皮瓣 手指C形软组织缺损 外科手术 

分 类 号：R658.2[医药卫生—外科学]