尺动脉腕上皮支皮瓣和骨间前动脉腕背支皮瓣在复杂断掌再植中的应用

Application of skin flaps with supra-carpal cutaneous branch of the ulnar artery and dorsal carpal branch of the anterior interosseous artery in reconstruction of complicated amputaled palm

目的探讨尺动脉腕上皮支皮瓣和骨间前动脉腕背支皮瓣在复杂断掌再植中的临床应用疗效。方法1999年8月～2005年10月共收治复杂断掌18例,根据复杂断掌中掌心、掌背皮肤的缺损程度,采用尺动脉腕上皮支皮瓣逆行转位修复掌心皮肤缺损,皮瓣大小:2～4cm×3～6cm;骨间前动脉腕背支皮瓣逆行转位修复掌背皮肤缺损,皮瓣大小:4～6cm×5～8cm;并同时完成断掌再植。结果所有再植断掌及皮瓣全部成活。根据相关功能评定标准,手部功能均恢复70%以上。结论利用尺动脉腕上皮支皮瓣和骨间前动脉腕背支皮瓣分别修复复杂断掌中的掌心、掌背皮肤缺损,可较好地重建手的外形与功能,有利于一期完成断掌再植。

Objective To investigate the clinical efficacy of carpal branch ofuinar artery skin flap and dorsal carpal branch of anterior interosseous artery skin flap in replantion of complicated severed hand. Methods From August 1999 to October 2005, 18 patients with complicated severed hands were treated in our department. According to the skin defect of severed hand, the palm of the hand was restored with upper carpal branch of ulnar artery skin flap （2-4 cm×3-6 c m）, followed by restoration of the back of the hand with dorsal carpal branch of anterior interosseous artery skin flap （4-6 cm×5-8 cm） and replantation of the hand was performed simultaneously. Results All the replanted hands and the skip flaps survived after the surgery with satisfactory shape and function. The surgery achieved an over 70% recovery of the hand function in all cases. Conclusions For complicated severed hands, upper carpal branch of the ulnar artery skin flap and dorsal carpal branch of the anterior interosseous artery skin flap are effective to repair the skin defect, and this procedure provides a good option for reconstructing shape and function of the severed hands.