掌背皮神经及指动脉岛状皮瓣瓦合修复食指皮肤脱套伤

Combined Transfer of the Neurocutaneous on Dorsal Part of the Hand and Digital Neurovascular Island Flap for the Degloved Injuries of the Index Finger

目的 :探讨临床修复食指皮肤脱套伤的一种新方法。方法 :10只成人新鲜手标本 ,显微镜下解剖观察桡神经浅支—掌背皮神经在手部的走行、分布情况及其横径的大小。临床设计以掌背皮神经营养血管为蒂的逆行岛状皮瓣和中指尺侧指动脉岛状皮瓣瓦合 ,急诊修复食指皮肤脱套伤 6例 6指。结果 :临床应用 6例 ,皮瓣全部成活 ,术后随访 6～ 12个月 ,伤指除缺少指甲及稍短外 ,外形及皮肤色质与健指相似 ,食指掌侧远端指腹两点辨别觉为 3 .5～ 6 .0mm ,运动功能按TAM系统标准评价 :优 1指 ,良 3指 ,可 2指。结论 :掌背皮神经营养血管为蒂的逆行岛状皮瓣和中指尺侧指动脉岛状皮瓣瓦合是修复食指皮肤脱套伤的一种良好方法。

Objective: To introduce a new procedure for repairing the degloved injuries of index finger.Methods 10 fresh cadaver hands were used and dissectted to examine the superficial radial nerve-the neurocutaneous on dorsal part of the hand under microscope.On the basis,design retrograde island flap pedicled with the neurocutaneous on dorsal part of the hand and digital artery island flap from the ulnar side of the middle finger to repair the degloved injuries of index finger.emengeniy opelation was performed in 6 cases.Results All the transplants survived,fellow up 6-12months after operation.The apperance and function of the index finger were satisfactory.Conclusion This procedure provides a good method for repair the degloved injuries of index finger.