大鱼际远近端逆行岛状皮瓣修复拇指软组织缺损的临床应用

Clinical application of retrograde proximal and distal thenar flap for coverage of soft tissue defect of the thumb

目的 总结大鱼际远、近端逆行岛状皮瓣在修复拇指软组织缺损中的临床应用。方法 根据拇指掌、背侧软组织缺损的不同部位，采用大鱼际逆行远端岛状皮瓣修复17例，大鱼际逆行近端岛状皮瓣修复5例。结果 术后22例皮瓣全部存活，供、受区伤口均Ⅰ期愈合。术后20例获得9—18个月的随访，2例失访。皮瓣弹性、色泽良好，两点分辨觉为7～10mm。拇指功能恢复优16例，良3例，中1例，优良率达95％。供区大鱼际处留有瘢痕，拇对掌功能无影响。结论 大鱼际远、近端逆行岛状皮瓣可满足拇指大部分软组织缺损的修复需要。

Objective To evaluate the results of retrograde proximal and distal thenar flap for repairing thumb soft tissue defect. Methods According to the site of the soft tissue defect of the thumb, retrograde distal thenar island flap was used in 17 cases while retrograde proximal thenar island flap was used in5 cases. Results All 22 flaps survived completely. Primary wound healing was achieved in both donor and recipient sites. Twenty cases were followed-up for 9 to 18 months postoperatively. The repaired thumbs had good blood supply and excellent appearance with two point discrmination 7- 10 ram. The good and excellent rate of finger function reached 95% according to the provisional functional assessment criterion for upper limbs issued by the Hand Society of Chinese Medical Association. There was scar at the thenar area, but opposition was not impaired. Conclusion Proximal and distal thenar flaps can cover almost any soft tissue defect of the thumb.