拇指桡侧皮瓣治疗拇指远端皮肤软组织缺损

Clinical Observation of Treating Skin and Soft Tissue Defect in Distal Thumb with Thumb Radialis Flap

目的:探讨拇指桡侧皮瓣治疗拇指远端皮肤软组织缺损的适应证及疗效。方法:22例拇指远端皮肤缺损均为4.0cm×3.0cm以内的皮肤软组织缺损采用拇指桡侧皮瓣修复,供区采用游离植皮修复,或直接缝合;在拇指桡侧设计皮瓣,以指侧正中线为轴线,其蒂部转折点在软组织缺损区近端0.5cm～1.0cm处,不能超过拇指指间关节,皮瓣面积最大4.0cm×3.0cm,最小2.0cm×1.5cm,吻合指神经8例。结果:22例皮瓣全部成活,术后随访1个月～24个月,外形美观,质地柔软,吻合指神经的指腹两点分辨觉为6mm～8mm。结论:对于拇指远端或偏桡侧皮肤缺损面积为2.5cm×3.0cm以内者适用拇指桡侧皮瓣修复,其手术方法较简单,疗效满意。

Objective： To observe the effect of treating skin and soft tissue defect in distal thumb with thumb radialis flap and to discuss the method of treating it. Method： 22 cases of skin defect in distal thumb （ defect area less then 4. 0cm ×3.0cm） were treated with thumb radialis flap; donor site was repaired with free grafting or was sewed directly. The flap in thumb radialis was designed as taking finger＇s side linea mediana as the axis and the turning point of peduncle was designed at the position of 0. 5cm - 1. Ocm from the end of soft tissue damage area, but not surpassing the interphalangeal joint of thumb. The flap largest area was 4. 0cm × 3.0cm and least one was 2.0cm × 1.5cm. 8 cases received digital nerve suture. Result： 22 cases＇ flap were all survived. After 1 - 24months of followingup, the finger＇s appearance was artistic, texture was soft, two - point discrimination of finger pulp of sutured digital nerve was 6 - 8mm. Conclusion： For the skin injury defect within the area of 2. 5cm × 3.0cm in distal thumb or thumb radialis, the repairing of thumb radialis flap is a simple operation and can obtain satisfactory effect.