游离骨间后动脉穿支皮瓣在手指缺损创面的临床使用  

Free posterior interosseous artery perforator flap in the treatment of finger with skin and soft tissue defect

作　　者：吴穷 江吉勇 范江来 张德玉 王金玉 WU Qiong;JIANG Ji-yong;FAN Jiang-lai;ZHANG De-yu;WANG Jin-yu(The 5th Ward of Hand Microsurgery,Guangzhou Heping Orthopaedics Hospital,Guangzhou 510000,Guangdong,China)

机构地区：[1]广州和平骨科医院手显微外科五区,广东广州510000

出　　处：《中国骨伤》2023年第8期714-718,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨以游离骨间后动脉穿支皮瓣在手指缺损创面中的临床使用效果。方法:选取2021年5月至2022年11月收治的8例手指皮肤软组织缺损患者,男7例,女1例;年龄24~54岁;手指皮肤软组织缺损面积3.0 cm×1.5 cm~5.0 cm×3.0 cm。受伤至皮瓣修复手术时间3~83 h。所有患者采用游离骨间后动脉穿支皮瓣修复手指缺损创面,皮瓣切取面积3.5 cm×2.0 cm~5.2 cm×3.5 cm,皮瓣供区均直接缝合关闭。观察术后皮瓣成活,外观、质地及供区并发症,并采用Dargan功能标准评定手指功能评价临床疗效。结果:8例患者皮瓣均成活,随访时间3~12个月。皮瓣无明显臃肿、质地柔软,无明显色素沉着,供区仅留线性瘢痕,未见明显并发症。其中3例修复手指掌侧缺损创面的皮瓣感觉恢复良好,两点辨别觉5~9 mm。患指关节Dargan功能评价,优3例,良5例。结论:游离骨间后动脉穿支皮瓣修复手指缺损创面,皮瓣厚薄适中,手术切取方便,术后皮瓣外观及质地良好,供区创伤小,无明显并发症,临床疗效满意。Objective To explore clinical effects of repairing skin and soft tissue defect of finger with free posterior interosseous artery perforator flap.Methods Totally 8 patients with finger skin and soft tissue defect repaired with free posterior interosseous artery perforator flap were treated from May 2021 to November 2022,including 7 males and 1 female aged from 24 to 54 years old,and soft tissue defect area ranged from 3.0 cm×1.5 cm to 5.0 cm×3.0 cm.The time from injury to flap repair ranged from 3 to 83 h.The free posterior interosseous artery perforator flap was applied to repair finger defect,the area of the flap ranged from 3.5 cm×2.0 cm to 5.2 cm×3.5 cm,the donor area of flap was sutured directly.The survival,appearance,texture and donor complications of the flap were observed after operation,and Dargan functional standard was used to evaluate clinical effect of finger function.Results All flap of 8 patients were survived,and followed up from 3 to 12 months.There was no obvious swelling,soft texture,obvious pigmentation,linear intaglio in donor area only,and without obvious complications were found.Among them,3 patients’skin flaps were repaired for the defect of palm of the fingers,and sensory recovery was good,two-point discrimination ranged from 5 to 9 mm.According to Dargan functional evaluation,3 patients excellent,and 5 good.Conclusion Free posterior interosseous artery perforation branch flap could be used to repair the defect of finger.The thickness of flap is moderate,operation is convenient,appearance and texture of the operative flap are good,and the donor site is small without obvious complications,and obtain satisfactory clinical effect.

关 键 词：骨间后动脉 游离穿支皮瓣 手指皮肤软组织缺损创面 

分 类 号：R658.1[医药卫生—外科学]