延长血管蒂的掌背动脉逆行岛状皮瓣的临床应用

Clinical application of extended vascular pedicled dorsal metacarpal artery with reversed island flap

目的探讨延长血管蒂的掌背动脉逆行岛状皮瓣修复手指中远节软组织缺损的可行性和临床方法。方法利用掌背动脉与指背动脉的相连续性,指背动脉的终末支与指固有动脉的背侧支在手指近节中、远1/3区相吻合,并以此为转点设计皮瓣,临床应用13例。结果皮瓣全部成活,随访6～12个月,皮瓣两点分辨觉7～9mm(平均8.1mm),皮瓣厚薄适中、质地良好、外形满意。结论该皮瓣是修复手指较大范围缺损的较好方法,并能同时进行肌腱修复及感觉功能重建。

Abstract： [Objective] To discuss the procedure and the clinical experience of lengthening vascular pedicled dorsal metacarpal artery reversed island flap to repair soft tissue defect distal to the middle segment of finger. [Methods] Using the continuance of the dorsal metacarpal artery and dorsal finger artery, the end branch of dorsal finger artery and dorsal finger proper artery are intersected at 1/3 proximal finger joint, and design the flap with the turn point, and we applied this method in 13 cases. [Result] All flaps survived in 13 cases, after 6 to 12 months, the two-point discrimination was 7 to 9 nun （average 8.1 ram）, the flaps thinkness were fit, the texture was excellent, the outer aspect was satifactory. [Conclusion] The flap was a good way to repair the hand large range tissue defect and meanwhile repair the muscle tendon and rebuild feeling function.