筋膜血管神经蒂食指背皮瓣急诊修复拇指缺损

The emergency reconstruction of thumb defect with index finger flap pedicled with fascial,vascular and nerve

目的:探讨筋膜血管神经蒂食指背皮瓣急诊修复拇指缺损的方法及疗效。方法:2010年10月～2012年6月,笔者单位应用筋膜血管神经蒂食指背皮瓣急诊修复拇指缺损患者共23例.男16例,女7例。年龄16～46岁,以中青年务工者居多。左侧10例.右侧13例,挤压毁损伤6例,撕脱伤8例,电锯伤9例:伤情均为拇指末节指骨或肌腱外露,皮肤软组织缺损。结果:术后除1例皮瓣远端血运不佳经换药创面愈合外,其余皮瓣全部成活,术后外形及功能良好,术后均有触、痛、温觉,患者均较满意。结论:筋膜血管神经蒂食指背皮瓣修复拇指缺损具有操作简单,手术一次完成,不需细小血管吻合技术,不需特殊设备,术后外形美观等优点。是年轻医生急诊处理拇指缺损的的理想方法。

Objective To investigate the method and clinical application of using index finger flap pedicled with fascial,vascular and nerve for reconstruction of the thumb defect. Methods 23 cases of thumb defects,from October 2010 to June 2012, were reconstructed with index finger flap pedicled with fascial,vascular and nerve in emergency.Patients were 16 men and 7 women ranging from 16 to 46 years old, with the exposition of thumb nonessentials phalanx or tendon and skin defects. Results All of the flaps were survived with good appearances and functions, except one case with bad blood supply in the distal end was healed after dressing treatment. Conclusion Applying index finger flap pedicled with fascial,vascular and nerve for reconstruction of the thumb is an ideal treatment for young doctors to choose in emergency operation. It has the advantages of simple operation, no special equipment, satisfied appearance, and being achieved through one stage.