外科皮瓣重建修复指端缺损

Surgical Treatment Strategy for Distal Finger Injuries

【目的】探讨应用外科皮瓣重建指端缺损的疗效并探讨其治疗策略。【方法】回顾性分析2003年1月至2008年12月采用伤指邻近皮瓣和游离足趾皮瓣修复手指指端缺损285例328指的临床资料。【结果】术后伤指邻近皮瓣中有13例手指袁浅坏死，游离足趾皮瓣全部成活。术后随访2周～1年，皮瓣的血运、质地、弹性良好，感觉以指神经血管束蒂皮瓣恢复最佳，与术前相近似；游离足趾皮瓣、侧支血管皮瓣的两点辨别觉为5～10mm，手指活动好，外观令人满意。【结论】严格掌握手术适应证，选择伤指邻近皮瓣和游离足趾皮瓣可修复指端缺损创面，并获得良好的修复外形和满意的功能恢复。

[Objective] To explore the effect of surgical flaps in the reconstruction of distal finger injuries and its therapy strategy. [Methods] The clinical data of distal finger injuries reconstructed with adjacent flaps and free toe flaps from January 2003 to December 2008 were analyzed retrospectively. [Results] After surgery, 13 adjacent flaps of injured fingers occurred superficial necrosis, and other free toe flaps all survived. The follow up for 2 weeks to 1 year after operation revealed that the flaps had good blood supply, texture and elas ticity. The neurovascular pedicle flaps of the fingers had the best recovery of the sensation reaching to the sensation before operation. The two-point discrimination of free toe flaps and collateral vascular flaps were 5-10mm. The finger motion ability was good and the finger appearance was satisfactory. [Conclusion] Mastering operation indications strictly and choosing adjacent flaps and free toe flaps can effectively repair the defects of distal fingers, and achieve favorable restoration contour and satisfactorv function reeoverv.