同指顺行神经血管蒂岛状皮瓣修复指腹指端缺损

Transfer of dorso-lateral neurovascular island antergrate flap from the same digit for pulp loss and digit tip injury

目的探讨同指顺行神经血管蒂岛状皮瓣修复指腹、指端缺损的手术疗效。方法23例指腹或指端缺损的患者,采用同指顺行带指神经血管蒂皮瓣移位修复。切取皮瓣面积1.3cm×1.5cm～2.0cm×2.5cm。结果23例皮瓣全部成活,无静脉回流障碍,供区创面一期愈合,术后随访6～16个月,皮瓣外形满意、质地柔软、弹性好、色泽与正常接近,皮瓣不臃肿能耐寒,伤指无疼痛。两点分辩觉达6～10mm。手功能按TAM法评定,优13指,良8指,可2指,优良率达91%。结论同指顺行带指神经血管蒂岛状皮瓣移位,皮瓣供区靠近创面,手术方法简便,术后功能及外形满意,是治疗指腹、指端缺损的一种比较理想的术式选择。

Objective To observe the treatment outcome of using dorso-lateral neurovascular island antergrate flap from the same digit for pulp loss and digit tip injury.Methods 23 cases of the pulp loss and digit tip injury were treated with. the digital neurovascular island antergrate flap from the same digit for pulp loss and digit tip injury. The sizes of the flaps were 1.3cm×1.5cm to 2.0cm×2.5cm.Results All the 23 transferred flaps survived.The period of follow-up ranged from 6 to 16 months. The flaps had good appearance and texture. No patients complained of pain or cold intolerace. The mean static two-point discrimination was 6mm to 10mm . According to the TAM standard, the results were excellent in 13 cases, good in 8, fair in 2, with 91% overall excellent and good rate.Conclusion The digital neurovascular island antergrate flap from the same digit for pulp loss and digit tip injury. The technique is simple, and the result is satisfactory, It is a good option for reconstruction of the same digit for pulp loss and digit tip injury.