逆行指背神经营养血管筋膜蒂皮瓣修复全甲床缺损  

Retrograde dorsal digital nerve nutrient vessel fascial pedicle flap for repairing total nail bed defects

作　　者：王连存 张海生[1] 周庆文[1] 孙海艳[1] 刘广超 王超 许鹏飞 WANG Lian-cun;ZHANG Hai-sheng;ZHOU Qing-wen;SUN Hai-yan;LIU Guang-chao;WANG Chao;XU Peng-fei(Dept of Hand-foot Surgery,Yutian County Hospital,Tangshan,Hebei 064100,China)

机构地区：[1]玉田县医院手足外科,河北唐山064100

出　　处：《临床骨科杂志》2024年第5期672-674,共3页Journal of Clinical Orthopaedics

基　　金：河北省卫健委医学科学研究重点计划(编号:20181367)。

摘　　要：目的探讨逆行指背神经营养血管筋膜蒂皮瓣修复全甲床缺损的疗效。方法采用逆行指背神经营养血管筋膜蒂皮瓣修复25例全甲床缺损患者。观察皮瓣成活情况及手指功能情况。结果患者均获得随访,时间1~3个月。患指创面均治愈,无皮瓣坏死发生。术后1个月患指近指间关节屈曲60°~90°,伸直0°。末次随访时,皮瓣质地优良,外形美观,不臃肿,无明显色素沉着,无手指屈伸活动障碍,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价疗效,25例均为优。结论采用逆行指背神经营养血管筋膜蒂皮瓣修复全甲床缺损,操作简单,皮瓣易成活,手指功能恢复较好。Objective To investigate the efficacy of retrograde dorsal digital nerve nutrient vessel fascial pedicle flap in repairing total nail bed defects.Methods The 25 patients with total nail bed defects were repaired by using retrograde dorsal digital nerve nutrient vessel fascial flaps.The survival of the skin flaps and the function of the fingers were observed.Results All patients were followed up for 1~3 months.All wound surfaces of affected fingers were cured,and no skin flap necrosis occurred.One month after surgery,the flexion range of motion of the proximal interphalangeal joint was 60°~90°and extension was 0°.At the last follow-up,the skin flap had excellent texture,beautiful appearance,there was no bulkiness,no obvious pigmentation,and no finger flexion and extension movement disorders.At the last follow-up,the therapeutic effect was evaluated according to the trial criteria for evaluating upper limb function of the Chinese Society of Hand Surgery,and all 25 cases were excellent.Conclusions The use of retrograde dorsal digital nerve nutrient vascular fascial pedicle skin flap for repairing total nail bed defects is simple to operate,the flap is easy to survive,and finger function recovery is better.

关 键 词：甲床缺损 筋膜蒂皮瓣 皮肤缺损 

分 类 号：R658.2[医药卫生—外科学] R622.1[医药卫生—临床医学] R686