第一掌背神经伴行血管及筋膜蒂皮瓣结合指固有神经血管蒂修复拇指脱套伤

Repairing the Decapping Injury of Thumb with the First Metacarpal Dorsal Neurocutanous Vascular Flap Incorporating the Flap Pedicled with Digital Palmar Propria Nerve and Vessels

目的：介绍一种修复拇指脱套伤的新方法。方法：从深筋膜下取第一掌背神经伴行血管皮瓣，蒂部筋膜宽约 ３．０ｍｍ～４．０ｃｍ，皮瓣面积 ３．０ｃｍ～３．５ｃｍ×５．５ｃｍ～６．５ｃｍ，逆行覆盖拇指背侧。取环指固有神经血管皮瓣，面积２．０ｃｍ～２．５ｃｍ×５．０ｃｍ～５．５ｃｍ覆盖拇指掌侧。结果：皮瓣全部存活。结论：该方法损伤小，操作简单。修复后拇指感觉好，两点分辩觉４ｍｍ～６ｍｍ。

Objective: To introduce a method of the repairing decapping injury of thumb. Methods: Fasciocutaneous flap pedicled with first metacarpal dorsal nerve and its nutrient vessels was treated with the deep fascia which its base were 3.0cm-4.0cm in wide to cover the dorsal retrograde. The flap pedicled with digital palmar thumb. Results: All the flaps were survived. Conclusions: This method was simple with less injury and the sensation of the restored thumbs was good. The distance of two-point discrimination was 4mm-6mm.