掌背皮神经筋膜皮瓣在拇指末节损伤中的应用

Clinical Application of Neurofasciocutaneous Flap on Dorsal Part of Hands for Repair of Distal Thumb Injury

【目的】应用掌背皮神经筋膜皮瓣掌侧移位修复拇指末节软组织缺损并观察其效果。【方法】对13例拇指末节软组织缺损病例 ,采用掌背皮神经筋膜皮瓣 ,经指蹼皮下隧道逆行移位至手掌侧远端 ,屈曲拇指贴紧手掌固定 ,皮瓣带蒂修复创面 ,2～ 3周后断蒂。【结果】皮瓣全部成活 ,随访 3～ 15个月 ,皮瓣质地柔软、弹性好、耐磨 ;指端饱满 ,色泽正常 ;指腹两点辨别觉 6 .4～ 8.6mm ,外观及功能满意。【结论】应用掌背皮神经筋膜皮瓣掌侧移位修复拇指末节软组织缺损 ,效果良好。

To introduce a neurofasciocutaneous flap on dorsal part of hands for repair of the soft tissue defect in the distal thumb. and observe its therapeutic efficacy.For treatment of 13 cases with distal thumb injuries, the neurofasciocutaneous flap on dorsal part of hand was moved to the distal palm side of the injured thumb via a tunnel beneath the first web space. The thumbs were then bent and fixed to the palm. The surfaces of wounds were repaired by island flap with peduncles, which were severed 2～3 weeks later.All flaps survived in 13 cases.The color and texture of the flaps were nearly normal, showing good elasticity, satisfactory appearance and function during follow-up for 3～15 months. The sensation of differentiation between two points on the palm side of the thumb covered 6.4～8.6 mm.[Conclusion]The neurofasciocutaneous flap on dorsal part of hands is a reliable one with easy dissection and good texture for repair of soft tissue defect in the distal thumb.