双侧指血管神经束推进皮瓣修复指端缺损

Bilateral digital neurovascular advancement flap to repair fingertip defects

目的探讨双侧指血管神经束推进皮瓣修复指端缺损的临床疗效。方法2010年1月至2011年10月，对9例指端缺损的患者，缺损面积为2．0cm×1．8cm～1．5cm×1．5cm，采用带指血管神经束的双侧推进皮瓣进行修复。结果术后9例皮瓣完全存活，随访时间14—20个月，平均16个月。患指指腹饱满，无勾甲，皮瓣外形良好，指端正中瘢痕元触痛，两点分辨觉3～5mm。出汗功能正常，指间关节伸屈功能0°-60°。按中华医学会手外科学会上肢部分功能评定试用标准评定，9例全部为优。结论双侧指动脉顺行推进皮瓣修复指端软组织缺损是一种手术方法简单，并可获得良好的外形及功能的术式，是修复指端缺损较好的手术方法。

Objective To investigate the ciinieal effects of bilateral digital neurovascular advancement flap for repair of soft tissue defects of the fingertip. Methods From January 2010 to October 2011, 9 cases of fingertip defects were treated with bilateral digital neurovascular advancement flap from the same finger. The defect sizes ranged from 2.0 cm × 1.8 cm to 1. 5 cm × 1.5 cm. Results All 9 flaps survived after the operation. These eases were follow-up for 14 to 20 months, 16 months on average. The flaps had good appearance and fingartips were full. There was no hooked nail deformity and tenderness of the scar in the pulp. Two-point discrimination was 3 to 5 mm. Sweating was normal. The function of finger motion returned to （P to 60°. According to the upper limb function assessment criteria issued by the Chinese Hand Surgery Society, the results of the 9 eases were graded as excellent. Conclusion Transfer of bilateral digital nettrovaseular advancement flap for reconstruction of fingertip defect is a simple and ideal method for reconstruction of thumb or finger tip defects with satisfactory clinical results.