上臂外侧骨皮瓣移植修复手部复合伤

Transfer of upper limb lateral bone-skin flap for repair of hand composite injury trauma

目的 介绍应用游离上臂外侧骨皮瓣移植修复手部软组织并掌骨缺损的手术疗效。方法 对19例手部软组织及掌骨缺损的患者，设计带桡侧副动脉后支的肱骨下段骨皮瓣一期修复皮肤和骨缺损。结果 骨皮瓣全部存活，术后随访6～12个月，皮瓣质地优，移植骨块全部骨性愈合，手功能按手外科学会上肢部分功能评定试用标准评定，优18例，良1例。结论 游离上臂外侧骨皮瓣切取方便，血供可靠且不损伤主要血管，是修复手部组织伴骨缺损的较好方法。

Objective To report the treatment outcome of transfer of the free upper limb lateral bone-skin flap for repair tissue and metacarpal bone defects in the hand. Methods Nineteen hand soft tissue combined with bone defects were repaired with bone - skin flaps primarily, whose pedicle was the posterior branch of radial collateral artery, Results All the bone- skin flaps were completely survived. On postoperative 6 to 12 months follow- up, the texture of the flap was excellent, and bone union was obtained in all transplants. According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association, the hand function had excellent results in 18 cases and good result in i case. Conclusion The bone- skin flap has advantages of easy dissection, reliable blood supply, and no major blood vessel needed to be sacrificed, which is an effective procedure for repair of hand soft tissue and bone defect.