指背岛状皮瓣一期修复手指皮肤缺损合并神经缺损

One-stage repair of soft tissue and nerve defect of the fingers nsing dorsal island flap

目的报告同指指背岛状皮瓣携带指神经背侧支一期修复手指皮肤缺损合并神经缺损的临床效果。方法对16例18指手指皮肤缺损伴一侧神经断裂缺损应用携带指神经背侧支同指指背岛状皮瓣修复，重建手指感觉。皮肤缺损面积为10mm×7mm～24mm×20mm。神经缺损长度9～22mm。结果16例18指皮瓣全部存活，随访5～25个月，手指功能及外观恢复满意，伤侧指腹感觉恢复至S3＋，两点分辨觉恢复至4～7mm。结论同指指背岛状皮瓣携带指神经背侧支修复手指皮肤缺损合并神经缺损，能同时完成皮肤覆盖和神经缺损的修复，术后效果满意，是治疗手指皮肤合并神经缺损并重建感觉较为理想的方法。

Objective To report the treatment outcomes of repairing soft tissue and nerve defect of the fingers using dorsal island flap carrying dorsal cutaneous branch of the proper digital nerve. Methods The skin and nerve defects in 18 fingers of 16 patients were repaired by dorsal island flap carrying dorsal cutaneous branch of the proper digital nerve. The size of the flaps ranged from 10 mm × 7mm to 24 mm× 20 mm. The length of the nerve defect ranged from 9 to 22 mm. Results Postoperatively all the flaps in the 18 fingers of 16 patients survived. The average follow-up was 5 to 25 months. The appearance and function of the involved fingers were satisfactoly. Sensation of the finger pulp returned to S3 ＋ and two-point discrimination ranged between 4 to 7 ram. Conehtsion Using dorsal island flap carrying dorsal cutaneous branch of the proper digital nerve can achieve simultaneous repair of both skin and nerve defects. The treatment outcomes were satisfactory. It is an optimal procedure for repairing combined soft tissue and nerve defect of the fingers.