骨间背侧动脉岛状皮瓣治疗虎口狭窄的疗效分析

Application of the reversed posterior interosseous artery flap in the contractures of the first web space

目的 回顾应用骨间背侧动脉岛状皮瓣治疗虎口狭窄的临床效果.方法 对虎口狭窄进行彻底松解后,以尺骨茎突上1.5～2.0 cm处为旋转点,根据虎口区皮肤缺损面积设计骨间背侧动脉皮瓣逆行转移治疗虎口狭窄中重度畸形42例,测量手术前后虎口大小,并进行统计学分析.结果 皮瓣全部成活39例,表皮部分坏死3例.31例获得随访,平均18个月,虎口宽度增加28～52 mm,平均37.9 mm.术后康复治疗能明显增加治疗效果,虎口宽度平均多增加8.6 mm.结论 骨间背皮瓣是治疗严重虎口狭窄的一种理想方法,术后固定及系统的康复治疗对保证治疗效果有着重要的作用.

Abstract：Objective To assess and review the methods of the reversed posterior interosseous artery flap for treating the contracture of the first web space. Methods Forty-two cases of the first web space severe contracture were cured by the reversed posterior interosseous artery flap rotate at 1.5-2.0 cm proximal ulnar styloid process after release the adhesion. After operation curative effects were evaluated by measuring the first web space with Gu＇s method. Results The flap of 42 cases obtain success, however 3 cases was partly necrosis of epidermis. Follow-up examination was obtained in 31 cases for average 18 months after operative.The width of the first web space was augmented an average of 37.9 mm. Rehabilitation training after operation can enhance the effect of the therapy with 8.6 mm more expanded. Conclusion The flap is an ideal choice for treatment on the defect of the contracture of the first web space and rehabilitation training after operation is important.