同指带指神经血管拇背尺侧岛状皮瓣修复拇指腹缺损

Transfer of digital neurovascular island flap from dorso-ulnar side of the same digit for repair of pulp loss in the thumb

目的探讨拇指指腹缺损的显微修复方法。方法对9例拇指指腹缺损的患者,采用同指带指神经血管拇背尺侧岛状皮瓣移位修复。皮瓣缺损面积为2．0cm×1．5cm～3．0cm×3．0cm。结果 9例皮瓣全部成活,术后随访3～6个月,皮瓣外形满意,质地柔软,弹性好,两点分辨觉达6mm～10mm,拇指屈伸活动良好。结论同指带指神经血管蒂拇背尺侧岛状皮瓣移位,手术方法简单,术后功能、外形满意,是一种修复拇指指腹缺损较理想的术式选择。

Objective To introduce a new prooedure of microsurgical repair of pulp defect in the thumb. Methods 9 cases of defects of the pulp in the thumb were treated with the new flap. The digital neurovascular island flap from dorso-ulnar side of the same thumb was designed and transferred to cover the pulp defects of the thumb. The sizes of the flaps were 2.0cm × 1.5cm to 3.0cm × 3.0cm. Results All the 9 transferred flaps survived. The period of follow-up ranged from 3 to 6 months. The flaps were soft and piablc. The function of the reconstructed thumbs was satisfactory. 2-point discrimination was 6-10 mm. Good finger motion was obtained. Conclusion The digital neurovascular island flap from dorso-ulnar side of the same digit offers a sensate skin flap for repair of thumb pulp defect. The technique is simple, and the result is satisfactory. It is a good option for reconstruction of thumb pulp loss.