鱼际穿支动脉岛状皮瓣修复拇指指腹缺损  

Repair of thumb pulp defect by island flap with thenar perforating artery

作　　者：郭建欣[1] 石法亮[1] 王萌[1] 王宝平[1] 刘泽庆[1] 程英杰[1] 

机构地区：[1]胶南市人民医院骨科,山东胶南266400

出　　处：《实用手外科杂志》2004年第2期75-76,共2页Journal of Practical Hand Surgery

摘　　要：目的探讨一种新的拇指指腹缺损的修复方法。方法对30例成人手部血管进行解剖研究,在此基础上设计以鱼际穿支动脉为皮瓣供血动脉的鱼际岛状皮瓣,其循环途径为:拇指尺侧动脉→指掌弓→拇指桡侧动脉穴逆流雪→鱼际穿支血管→鱼际血管网→鱼际穿支伴行静脉→拇指桡侧动脉伴行静脉穴逆流雪→手背静脉网。结果36例拇指指腹缺损病人接受鱼际穿支动脉岛状皮瓣修复,皮瓣最大面积3.5cm×3.0cm,最小面积2.5cm×2.0cm,全部成活。术后经2个月～4年随访,皮瓣外形饱满,色泽、质地与正常指腹相似,功能良好,两点辨别觉可恢复至5mm。结论鱼际穿支动脉岛状皮瓣成活率高,可切取面积范围大,操作简单,完全满足拇指指腹缺损的修复要求,且术后恢复快,指腹外形及功能满意,供区功能无明显影响,为拇指指腹缺损提供了一种新的修复方法。Objective To investigate a new method for repairing the defect of thumb pulp. Meth-ods The vascular anatomy was studied in30adult hands,and then the island-flap with thenar per-forating artery was designed,by which we could restore the defect of thumb pulp.After recon-struction,the blood circulation pathway was from ulnar artery of thumb→palmar arch→radial artery of thumb(reflux)→perforating artery of thenar→blood vessel net of thenar→thenar accompanying vein→radial vein of thumb(reflux)to dorsal venous net of hand. Results Thirty-six patients with thumb pulp defect were treated by using this kind of flap,and all flaps survived.The size of the flap ranged from3.5cm×3.0cm to2.5cm×2.0cm.During the follow-up from2months to4years,the reconstructed pulp of thumb had better appearance,satisfactory function and sensation(with5mm of2-PD). Conclusion The study indicates that the island-flap with thenar perforating artery is a reliable flap with easy dissection,good repairing of thumb pulp defect,and satisfactory function and sensation of the reconstructed pulp.It shows that this kind of reconstructing method is a new and ideal approach to repair the defect of thumb pulp.

关 键 词：鱼际穿支动脉 岛状皮瓣 修复 拇指指腹缺损 手术方法 

分 类 号：R658[医药卫生—外科学]