第二趾胫侧趾腹皮瓣修复手指软组织缺损

Tibial side pulp flap of the second toe for coverage of skin defect of the fingers

目的探讨第二趾胫侧趾腹皮瓣修复手指创面的手术方法和临床疗效。方法1997年起,应用第二趾胫侧趾腹皮瓣移植修复手指创面21例。其中单个皮瓣移植13例,与同侧趾腓侧趾腹皮瓣构成孪生皮瓣联合移植8例,皮瓣切取面积6.0cm×3.0cm^2.0cm×1.5cm。结果皮瓣全部成活。术后17例获得随访,随访时间1~3年。皮瓣肤色红润,质地良好,手指外形满意。按手功能评定标准评定[1]:优16例,良4例,优良率达95.2%。皮瓣两点分辨觉达6~10mm。结论第二趾胫侧趾腹皮瓣是修复手指软组织缺损,特别是手指纵形缺损创面的理想手术方法。

Objective To present the surgical procedure of tibial side pulp flap of the second toe to repair skin defect of the fingers and evaluate the outcomes. Methods Since 1997, 21 cases of soft tissue loss of the fingers were treated by pulp flaps harvested from the foot. 13 cases defects were covered with tibial side pulp flap from the second toe only, while 8 cases were treated with combined pulp flaps from tibial side of the second toe and fibular side of the big toe. Sizes of the flaps ranged from 6.0cm × 3.0cm to 2.0cm × 1.5cm. Results All flaps survived. 17 cases had followed up for 1 to 3 years, The flaps had good consistency and color. Contour of the fingers was satisfactory. According to the provisional functional assessment criterion for upper extremity issued by the Hand Sooiety of Chinese Medical Association, functions of the fingers were graded excellent in 16 cases and good in 4 cases, the overall excellent and good rate being 96.7% . Two point discrimination recovered to 6 ～ 10mm. Conclusion Tibial side pulp flap of the second toe is an ideal flap which can be used to repair small or medium size defect of the fingers. It is especially ideal for those longitudinal defects.