游离骨间后动脉皮瓣桥接修复手指掌侧皮肤及动脉缺损

Reconstruction of combined skin and bilateral artey defects at palmar side of fingers by free posterior interrosseous artery flap in a bridge fashion

目的探讨携带长段骨间后动脉的游离骨间后动脉皮瓣桥接修复手指掌侧皮肤，以及双侧指动脉同时缺损的可行性及临床效果。方法应用携带长段骨间后动脉的游离骨问后动脉皮瓣，桥接修复了6例手指掌侧皮肤及双侧指动脉同时缺损的患者。皮瓣的切取面积为3．5cm×2．0cm～6．5cm×3．0cm。供瓣区创面直接拉拢缝合。结果6例移植的皮瓣术后均未发生血管危象，皮瓣均顺利成活，切口均一期愈合；6例桥接修复指动脉缺损的手指血供和回流良好。4例获得1-12个月（平均7个月）的随访，移植的皮瓣色泽、质地较好，皮瓣厚度略显臃肿；桥接修复指动脉缺损的手指成活良好；大部分患者供、受区的外形及功能恢复较为满意。结论携带长段骨间后动脉的游离骨间后动脉皮瓣桥接移植，可收到覆盖创面和改善或重建血供的双重功效，为手指掌侧皮肤及双侧指动脉同时缺损的修复提供了一种新的方法。

Objective To investigate the feasibility and therapeutic effect of free posterior interrosseous artery flap in a bridge fashion for combined skin and bilateral artery defects at palmar side of fingers. Methods 6 cases with combined skin and bilateral artery defects at palmar side of fingers were treated with long-pedicled free posterior interrosseous artery flap in a bridge fashion. The flap size ranged from 3.5 cm x 2. 0 cm to 6. 5 em ~ 3.0 cm. The wounds at donor sites were closed directly. Results All the 6 flaps survived completely without any complication, and the wounds healed primarily. The blood supply and vein drainage in all the 6 fingers were normal. 4 cases were followed up for 1-12 months （average, 7 months）. Satisfactory cosmetic and functional results were achieved. The flaps looked a little bit thicker than the surrounding tissue. Conclusions The long-pedicled free posterior interrosseous artery flap in a bridge fashion is a good option for reconstruction of the combined skin and bilateral artery defects at palmar side of fingers in one stage.