中环指岛状皮瓣、示指背侧岛状皮瓣转移修复拇指损伤

Transfer of island flaps from middle and ring finger and/or index finger dorsal island flap for the repair of injuries of the thumb

目的 评价中环指岛状皮瓣和（或）示指背侧岛状皮瓣转移修复拇指损伤的疗效。方法１９８９年７月～１９９８年１１月共８例拇指损伤应用中环指岛状皮瓣和（或）示指背侧岛状皮瓣修复。其中示指背侧岛状皮瓣转移修复拇指损伤２例，中指尺侧岛状皮瓣加示指背侧岛状皮瓣转移修复拇指脱套伤１例，中环指双岛状皮瓣转移修复拇指撕脱离断伤１例，中指尺侧岛状皮瓣转移修复拇指损伤４例。随访７个月～９年１１个月，平均５年１个月，主要观察皮瓣的质地，患拇指的外观、功能、长度和感觉。结果仅１例皮瓣小部分坏死，其余全部成活。转移的皮瓣质地良好，患拇指外观功能均较满意，能保留一定长度，感觉良好。结论中环指岛状皮瓣和（或）示指背侧岛状皮瓣转移修复拇指损伤，方法简单、可靠，疗程短。要使患拇指恢复自身感觉，必须将皮瓣的神经与拇指指神经缝合。

To evaluate the effect of repair of the thumb by transfer of island flaps from middle and ring fingers and/or index finger dorsal island flap. Methods The transfer of island flaps from middle and ring fingers and/or index finger dorsal island flap to repair injuried thumb has been performed in 8 patients from July 1989 to Nov. 1998. of them, transfer of index finger dorsal island flap was performed in 2 cases, transfer of middle finger ulnar island flap and index finger dorsal island flap in one case, transfer of double island flaps from middle finger and ring finger in one case. The external appearence, function, length, sensation of repaired thumbs were evaluated. Results The follow-up period ranged from 7 months to 9 years and 11 months. 8 flaps survived except 1 developed partial necrosis. All repaired thumbs had good appearence, function and sensation. Conclusion This method is simple and safe. In order to obtain good sensation, suturing of nerve should be performed.