臂外侧穿支皮瓣游离移植修复虎口挛缩  

Free transplantation of lateral arm perforator flap to repair thumb web contracture

作　　者：刘华 梅良斌 吕乾 张虎 王毅 何晓清 徐永清 Liu Hua;Mei Liangbin;Lv Qian;Zhang Hu;Wang Yi;He Xiaoqing;Xu Yongqing(Department of Orthopedics,the 920th Hospital of Joint Logistics Support Force of PLA,Kunming 650032,China)

机构地区：[1]解放军联勤保障部队第920医院骨科,昆明650032

出　　处：《中华手外科杂志》2023年第4期317-319,共3页Chinese Journal of Hand Surgery

基　　金：云南省骨科与运动康复临床医学研究中心(202102AA310068);云南省创伤骨科临床医学中心(ZX20191001)。

摘　　要：目的探讨应用臂外侧穿支皮瓣游离移植修复虎口挛缩松解后皮肤缺损的临床疗效。方法自2015年1月至2020年12月我们利用臂外侧穿支皮瓣游离移植修复22例虎口挛缩松解后皮肤缺损患者。虎口松解后拇指固定于外展位,虎口创面大小5 cm×2 cm~9 cm×4 cm,皮瓣切取面积大小6 cm×3 cm~10 cm×5 cm。术后观察皮瓣存活、拇指功能恢复以及受区及供区创面愈合情况。结果皮瓣切取顺利,术后全部存活。患者均获得随访,时间4~18个月。皮瓣外形、色泽、弹性恢复良好,厚薄适中,均未行二期皮瓣修薄手术。拇指活动不受限,无功能障碍。皮瓣两点分辨觉为5~10 mm,感觉良好。结论应用臂外侧穿支皮瓣游离移植修复虎口部位皮肤缺损,血管解剖较恒定,手术操作简便,皮瓣成活率高,虎口受区外形美观,拇指功能恢复良好,是修复虎口挛缩的有效办法。Objective To explore the clinical efficacy of free transplantation of lateral arm perforator flap for repair of skin defects after release of thumb web contracture.Methods From January 2015 to December 2020,a retrospective series study was conducted to analyze 22 patients who underwent free transplantation of lateral arm perforator flap to repair skin defects after release of thumb web contracture.After the thumb web contracture was released,the thumb was fixed on the abduction position.The size of the thumb web wound was 5 cm×2 cm to 9 cm×4 cm,and the area of the flap was 6 cm×3 cm to 10 cm×5 cm.The survival of the flap,the recovery of thumb function,and the wound healing of the recipient and donor sites were observed after operation.Results The flaps were removed successfully and all flaps survived after operation.All the patients were follow-up for 4 to 18 months.The shape,color and elasticity of the flaps recovered well,and the thickness was moderate.No secondary flap thinning operation has been performed.There was no restriction of thumb movement and no dysfunction.The two-point discrimination of the flap was 5 to 10 mm,and the sensation was good.Conclusion The application of free transplantation of the lateral arm perforator flap for repair of the skin defects of the thumb web is an effective method for repairing the thumb web contracture.The vascular anatomy of the lateral arm perforator flap is relatively constant,the operation is simple,the survival rate of the flap is high,the appearance of the thumb web recipient area is beautiful and the function of the thumb is restored well,which is an effective method for repairing thumb web contracture.

关 键 词：外科皮瓣 治疗结果 臂外侧穿支 虎口挛缩 

分 类 号：R687.3[医药卫生—骨科学]