同指尺侧岛状皮瓣远侧V-Y推进修复拇指指端缺损

Repair of thumb tip defect with thumb island flaps at ulnar side by V-Y advancement

目的 探讨一种修复拇指指端缺损的手术方法. 方法 对拇指指端缺损的患者采用同指尺侧岛状皮瓣远侧V-Y推进进行修复,术中切取皮瓣范围1.4 cm×2.0 cm～1.4 cm×2.5 cm,供区取前臂全厚皮片移植修复. 结果 2007年3月至2009年10月于临床应用10例,术后所有皮瓣和移植皮片均成活,伤口一期愈合.术后随访6～18个月,皮瓣质地柔软,无明显挛缩,末节指腹指纹重新建立,指间关节活动正常,无钩甲畸形发生,末节指腹两点辨别觉为5～6 mm. 结论 应用同指尺侧岛状皮瓣远侧V-Y推进的方法可以较好地修复拇指指端缺损.

Objective To investigate the method for treatment of thumb tip defect. Methods The thumb tip defect was treated with thumb island flaps at ulnar side by V-Y advancement.The flap size ranged from 1.4 cm× 2.0 cm～ 1.4 cm × 2.5 cm.The wounds at donor sites were covered by skin grafts. Results From March 2007 to October 2009,10 cases of thumb tip defects were treated.All the flaps and skin grafts were survived with primary healing.The patients were followed up for 6-18 months with both satisfactory functional and cosmetic results.The two-point discrimination was 5-6 mm at the thumb tip. Conclusions The thumb tip defect can be successfully repaired with thumb island flaps at ulnar side by V-Y advancement.