游离股前外筋膜瓣修复手部软组织缺损

Reconstruction of skin defect in opisthenar and palm with freeing anterolateral thigh fascial flap

目的设计游离股前外筋膜瓣修复手背、掌侧皮肤缺损。方法本组14例手部软组织缺损患者，肌腱移植修复后采用游离股前外筋膜瓣覆盖修复，筋膜瓣上游离植皮。结果筋膜瓣全部成活，植皮9例成活，其余5例部分出现坏死，经换药或点状植皮愈合。经6个月～2年随访，外观和功能满意。结论应用肌腱移植联合游离股前外筋膜瓣，一次手术完成手部肌腱、软组织、皮肤及感觉神经重建，术后外形、功能恢复满意，尤其对供区损伤降至最小，为手掌、背部皮肤软组织缺损提供了一种较好的修复方法。

Objective To design flee anterolateral thigh fascial flaps for the reconstruction of skin defects in opisthenar and palm. Methods Hand soft tissue defects in 14 patients were covered with freeing anterolateral thigh fascial flaps, and skin grafting on fascial flaps was performed after tendon transplantation The patients were then followed up. Results All fascial flaps survived. 9 cases of skin grafting survived, most of the remaining 5 cases of skin grafting survived at the first phase, and the remaining necrotic cases were healed by dressing or pinch skingrafting. After 6 months to 2 years of follow-up, the appearance and function were satisfactory. Conclusion The combination of tendon transplantation with free anterolateral thigh fascial flaps can complete the reconstruction of hand tendon, soft tissue, skin and sensory nerve defects in one operation. This method, easy to operate, having satisfactory postoperative recovery of appearance and function, minimizing the damage to the donor area, provides a way for the reconstruction of soft tissue defects in opisthenar and palm.