带旋髂深血管蒂髂骨瓣联合腹股沟皮瓣急诊拇指再造术临床观察

Emergency Treatment of Thumb Defect by Iliac Bone Craft Pedicled with Deep Circumflex Iliac Vessel Combined with Groin Flap

目的观察带旋髂深血管蒂髂骨瓣联合腹股沟皮瓣急诊拇指再造术的临床效果。方法自2009年2月-2012年5月，我科采用带旋髂深血管蒂髂骨瓣联合腹股沟皮瓣急诊拇指再造术修复拇指缺损12例。结果临床应用12例，皮瓣无感染、坏死；拇指残端与髂骨均发生骨性融合，平均随访1．2年，再造拇指无皮肤萎缩、溃烂不愈及植骨吸收现象，再造拇指末端掌侧两点感觉辨别实验平均12mm；拇指对指、对掌功能良好。结论采用带旋髂深血管蒂髂骨瓣联合腹股沟皮瓣急诊拇指再造术后，拇指外观佳、感觉可，植骨区感染风险小、愈合快，功能佳。

Objective To report the clinical effect of emergency reconstruction of thumb with vascular pedi- cled lilac bone flap and the groin flap was appraised. Methods From 2009 February to 2012 May,vascular pedicled ili- ac bone flap and groin flap was u sed to remold the thumb in 12 cases in our department. Results The average follow-up was 1.2 years. There had no infection and necrosis of skin flap, and thumb stump and iliac bone was bony fusion. The thumb reconstruction without the phenomenon of skin atrophy, fester, nonunion and bone absorption were observed. The thumb volar two end of sensory discrimination experiment was mean 12ram. The thumb opposition function was fine. Con- clusion Emergency reconstruction of thumb by vascular pedicled iliac bone flap and the groin flap has many advanta- ges：good appearance and feeling of thumb, small bone graft infection risk, fast healing and better function.