带神经的组织瓣分期修复全手脱套伤1例  

Phased reconstruction of a whole-hand degloving injury with tissue flaps carrying nerves:a case report

作　　者：代力臻 邹时雨 张宜之 陈品琨 肖春生 马立峰 王克列 DAI Lizhen;ZOU Shiyu;ZHANG Yizhi;CHEN Pinkun;XIAO Chunsheng;MA Lifeng;WANG Keie(Department of Hand Surgery,Longgang District Orthopaedic Hospital,Shenzhen 518116,China)

机构地区：[1]深圳市龙岗区骨科医院手外科,深圳518116

出　　处：《中华显微外科杂志》2024年第6期694-697,共4页Chinese Journal of Microsurgery

基　　金：深圳市龙岗区医学重点专科建设项目(440307240221533600176)。

摘　　要：2018年12月,深圳市龙岗区骨科医院手外科收治1例全手脱套伤的21岁男性患者,采用双侧甲瓣再造右手拇、示指及虎口区,中、环、小指并指后由左侧股前外侧皮瓣(ALTF)修复;右侧ALTF修复双足供区。2次分指手术后,行右中、环、小指指腹取皮,双足第2趾、左足第3趾侧方皮瓣修复右中、环、小指指腹创面。术后4年随访,拇、示指指甲逼真,各手指外形满意,各手指指腹区域未出现磨损、破溃,持物稳定性佳,TPD达4~6mm;双足无水疱、破溃;皮瓣柔软,双大腿仅留线状瘢痕。In December 2018,a 21-year old male with a whole-hand degloving injury was treated in the Department of Hand Surgery,Longgang District Orthopaedic Hospital.Two hallux nail flaps were used to reconstruct the right thumb,index finger and the first web.The wounds on middle,ring and little fingers were reconstructed with syndactyly by a left anterolateral thigh flap(ALTF).A right ALTF was used to reconstruct the donor sites in both feet.After 2 surgeries for finger splitting,the pulps of right middle,ring and little fingers were reconstructed with the pulps of the right middle,ring and little fingers together with the lateral flaps of the second toes of both feet and left third toe.After 4 years of follow-up,nails of the thumb and index finger were realistic and the shape of the fingers was satisfactory.There was no wear or ulceration in the finger pulps.The holding function was good with the TPD at 4-6 mm.There was no blisters or ulcers in both feet.The flap was soft.Only linear scars remained on both thighs.

关 键 词：脱套伤 手 组织瓣 移植 重建 

分 类 号：R658.2[医药卫生—外科学]