双叶皮瓣瓦合修复拇指脱套伤

Connect two pieces of selected skin flap to repair thumb deglved injury

目的介绍一种修复拇指脱套伤的新方法。方法采用从深筋膜下取第一掌背神经伴行血管皮瓣,蒂部筋膜宽约2.5～4.0cm,面积(3.0～3.5cm)×(5.0～5.5cm),覆盖拇指尺掌侧。取带拇背侧皮神经营养岛状皮瓣,面积(2.0～3.0cm)×(3.0～6.0cm),覆盖拇指桡背侧,瓦合修复拇指。结果临床应用9例皮瓣完全存活,随防12～36个月,皮瓣质地优良,外观及功能满意,经吻合神经后皮瓣能恢复部分感觉。结论该方法损伤小,操作简单,皮瓣外形好,修复后皮瓣感觉好,两点分辨觉4～6mm,为修复拇指脱套伤提供了一种较为理想的方法。

Objective To introduce a new method to degloved injury of thumb.Methods Select fasciocutaneus flap pedicled with first metacarpal dorsal nerve and its nutrient vessels from deep fascia with a width of 2.5cm×4.0cm and with a area of about （3.0-3.5cm） to （5.0m-5.5cm） in wide to cover the wound of thumb. The area of the flap shoud be about（2.0-3.0cm）×（3.0-6.0cm） to cover the dorsal side of thumb.Results 9 flaps all survived in 9 patients and had good apperance and functioned well in the following 12-36 months. The flaps which having dvetailed nerve acquired partial sense.Conclusion This method is simple with less injury and easy to operate, The flaps good appearance and function well after recovery,The distance of two point discrimination was 4-6mm. It is an ideal method to repair soft tissue defect of thumb.