以近节指动脉弓为旋转点的指背筋膜皮瓣的临床应用

详细信息    查看全文 | 推荐本文 |

英文篇名：Clinical application of dorsal digital fasciocutaneous flap with proximal digital artery arch as rotation point 作者：王红胜 ; 袁海平 ; 袁勇 ; 崔剑华 ; 樊川 ; 吴孙东 英文作者：WANG Hongsheng;YUAN Haiping;YUAN Yong;Department of Hand Surgery, Dongfeng People's Hospital of Zhongshan City; 关键词：手指 ; 近节指动脉弓 ; 缺损 英文关键词：Finger;;Arch of proximal digital artery;;Defect 中文刊名：SYSW 英文刊名：Journal of Practical Hand Surgery 机构：中山市东凤人民医院手外科; 出版日期：2019-06-20 出版单位：实用手外科杂志 年：2019 期：v.33 语种：中文; 页：SYSW201902028 页数：3 CN：02 ISSN：10-1336/R 分类号：84-85+116

摘要

目的探讨以近节指动脉弓为旋转点的指背筋膜皮瓣修复手指皮肤软组织缺损的临床效果。方法2016年10月-2018年2月,采用以近节指动脉弓为旋转点的指背筋膜皮瓣修复手指皮肤软组织缺损16例,其中拇指3例、示指4例、中指6例、环指2例、小指1例。结果 16例皮瓣全部成活,术后随访3～12个月,皮瓣色泽正常,质地柔软,无明显色素沉着,无明显肌腱粘连,患指外观及功能均满意。皮瓣均有部分感觉恢复,两点辨别觉8～12 mm。手功能按中华医学会手外科学会上肢部分功能评定试用标准手指关节总活动度(TAM)法评定:优9例,良5例,可2例。结论以近节指动脉弓为旋转点的指背筋膜皮瓣修复手指皮肤软组织缺损,方法可靠,临床疗效满意。
        Objective To investigate the clinical effect of digital dorsal fasciocutaneous flap with proximal digital artery arch as rotation point on repairing finger skin and soft tissue defect. Methods From October2016 to February 2018, 16 cases of finger soft tissue defects were repaired with the dorsal fasciocutaneous flap rotated at the proximal digital artery arch, including 3 cases of thumb, 4 cases of index finger, 6 cases of middle finger, 2 cases of ring finger and 1 case of small finger. Results All 16 cases survived and the follow-up time was 3～12 months. The skin flap had normal color, soft texture, no obvious pigmentation,no obvious adhesion of tendon, satisfactory appearance and function of the affected finger. All flaps have partial sensation. The two-point discrimination was restored to 8 ～12 mm. The hand function was evaluated according to the standard(TAM) method of the total motion of the finger joint according to the evaluation of the upper limb function of the Chinese Medical Association: excellent in 10 cases, good in 6 cases, fair in 2 cases. Conclusion The proximal digital artery arch is the rotation point of dorsal digital fasciocutaneous flap for the repair of finger skin and soft tissue defect. The method is reliable and the clinical effect is satisfactory.

引文

[1]刘玉林,冯亚高,徐翀,等.示指背神经血管蒂岛状皮瓣修复拇指远端缺损[J].实用手外科杂志,2017,31(1):38-39.
    [2]何俊峰,陈继峰,任义军,等.拇指末节部分缺损修复方法的选择与文献回顾[J].实用手外科杂志,2018,32(2):184-189.
    [3]李卫,夏海,孟庆刚,等.指侧方动脉皮支血管链皮瓣修复手指末节软组织缺损[J].实用手外科杂志,2014,28(3):259-260.
    [4]徐东卫,李方奇,章祥洲,等.拇指背侧动脉逆行皮瓣修复电击伤后拇指软组织缺损[J].中华手外科杂志,2013,29(3):159-160.
    [5]潘达德,顾玉东,侍德,等.中华医学会手外科学会上肢部分功能评定试用标准[J].中华手外科杂志,2000,16(3):130-135.
    [6]魏苏明,芮永军,薛明宇,等.指背侧岛状皮瓣在手指皮肤缺损中的临床应用[J].实用手外科杂志,2014,28(3):276-278.
    [7]陈政,许亚军,寿奎水,等.近节指背逆行岛状皮瓣修复手指皮肤缺损[J].中华手外科杂志,2010,26(1):1-3.
    [8]周吉林,姜华东,张晓明.拇指指背动脉的应用解剖[J].中国临床解剖学杂志,2001,19(4):333-334.