5种带皮神经的岛状皮瓣修复拇指指腹软组织缺损

Recovery of soft tissue defect in thumb puip by five kinds of island skin flap with cutaneous nerve

目的探讨5种带皮神经的岛状皮瓣修复拇指指腹软组织缺损的手术方法及临床效果。方法采用拇指尺或桡背侧皮神经伴行血管岛状皮瓣、示指背侧岛状皮瓣、中指尺侧或环指桡侧指神经血管蒂岛状皮瓣修复拇指腹缺损28例,皮瓣均含有感觉神经,皮瓣切取的最大面积5.5 cm×3 cm。结果28例皮瓣全部成活,经6~12个月随访,拇指指腹外形及感觉功能恢复优良,指腹两点辨别觉5~12 mm。结论严格选择适应证,5种带感觉神经的皮瓣血供可靠,操作简单,可较好的恢复拇指指腹的外形和感觉。

Objective To probe the results of 5 kinds of island skin flap with cutaneous nerve in repairing the pulp defect p of the thumb. Methods 28 flaps of 5 different kinds were devised to repair the pulp defect of the thumb：radial or ulnar dorsal concomitant vessel pedicled island flap of the thumb,dorsal island flap of the index finger,ulnar finger artery island flap of the middle finger,and radial finger artery island flap of the ring finger. All flaps included cutaneous nerves. The largest flap was 5.5 cm x 3 cm. Results Follow-ups for a period of 6 to 12 months. All the flaps survived with satisfactory shape and sensory restoration. Avrage of the two-point discrimination was 5 mm to 12 mm. Conclusion Each of these 5 sensory flaps can preserve satisfactory shape and good sensory function.