足背并联游离皮瓣修复手贯通伤

Repairing tissue defect of palm and dorsum of hand with united free flaps of foot back

目的探讨足背并联游离皮瓣修复手贯通伤的临床效果。方法1998-01～2007-01,笔者依据足背动脉在足部发出各分支的解剖特点,以足背动脉为主干,选择2个或2个以上的足背动脉分支为血管蒂,设计不同的足背并联游离皮瓣,修复手贯通伤,临床应用13例。结果本组13例皮瓣全部成活。随访16～21个月,外形满意,皮纹清晰,两点分辨觉5～7mm,手指功能良好。结论依据足背动脉在足背部发出分支的解剖特点,根据手掌背创面的大小、距离的远近,选择足背动脉不同的分支为血管蒂,设计足背并联游离皮瓣修复手贯通伤,血供可靠,手术简便、实用。

Objective To report the clinically outcomes of united flaps from the foot back to repair tissue defect of palm and dorsum of hand （i.e thorough injuries）. Methods From January 1998 to January 2007, according to the anatomical characteristics of ramification of the dorsal pedal artery and the wound shapes, skin of dorsum of foot was disintegrated into multiform flaps to repair tissue defect for palm and dorsum of hand. This operation was used to treat 13 cases of tissue defect of palm and dorsum of hand including bone,tendon and nerve loss and skin defect on both palm and dorsal. Results All of the flaps survived. Follow - up period ranged from 16 months to 21 months.Bone healing was achieved in all the cases; 2 point discrimination recovered to 5-7mm. Both appearance and texture of the flaps were good. Conclusion Various flaps may be designed to recover palm penetrating wound according to the anatomical characteristics of ramification of the dorsal pedal artery and the wound shapes. The operation was convenient and practical. Foot back is good donor to recover tissue defect of palm and dorsum of hand.