示指背侧皮瓣与蹲趾腓侧皮瓣瓦合修复拇指套脱伤

Combined transfer of dorsal island skin flap of the index finger and fibular side flap of the great toe for repair of degloving injury of the thumb

目的介绍应用示指背侧岛状皮瓣与游离鼹趾腓侧皮瓣瓦合修复拇指套脱伤的临床方法。方法对9例残留甲床的拇指套脱伤患者，采用示指背侧岛状皮瓣与躅趾腓侧游离皮瓣瓦合进行修复。结果术后9例拇指瓦合皮瓣全部存活，随访时间为6个月至3年，皮瓣颜色、质地良好，拇指指甲生长良好，外形和功能满意，皮瓣两点分辨觉为8～10mm。供区示指及足趾植皮区愈合良好，无明显功能影响。结论示指背侧岛状皮瓣与游离蹰趾腓侧皮瓣瓦合修复是治疗残留甲床的拇指套脱伤的一种较好方法。

Objective To introduce the clinical application of dorsal island flap of the index finger combined with vascularized transfer of fibular pulp flap from the big toe to treat thumb degloving injuries. Methods There were 9 cases of degloved thumbs with intact nail bed in this series. A local island flap from dorsum of the index finger was transferred along with a free vascularized fibular pulp flap from the big toe to cover the soft tissue defect. Results The patients were followed-up for 6 months to 3 years. All the flaps survived,with excellent color and texture. Nail growth was near normal and appearance and function of the thumb was satisfactory. 2-PD was 8-10 mm. Wound and skin graft at the donor sites healed well and there was no functional impairment. Conclusion Combined transfer of dorsal island flap of the index finger and fibular side flap of the great toe was one of the best options to treat degloving injury of the thumb.