远端蒂鱼际肌肌皮瓣修复拇指创面的临床应用

Clinical application of distally based thenar muscle musculo - cutaneous flap in repair of thumb wounds

目的：探讨远端蒂鱼际肌肌皮复合组织瓣修复拇指特殊创面的临床疗效。方法：采用远端蒂鱼际皮瓣复合拇短展肌和（或）拇短屈肌,修复拇指重度软组织缺损或合并指骨骨髓炎18例。结果：18例组织瓣中16例全部存活,2例皮瓣远端部分坏死,经换药处理后创面愈合,术后2月~1年随访,皮瓣质地优良,无臃肿、无挛缩、感觉恢复较满意,两点分辨觉为3-6 mm。拇指对掌对指功能良好。结论：远端蒂鱼际肌肌皮复合组织瓣修复拇指重度软组织缺损或合并指骨骨髓炎等创面的临床疗效满意。

Objective： To discuss clinical efficacy of distally based thenar muscle musculo-cutaneous flap in repair of special wounds of thumb.Methods： Distally based thenar muscles musculo-cutaneous flap combined with abductor pollicis brevis and / or short flexor muscle was applied for repairing 18 cases with severe soft tissue defects of the thumb or phalangeal osteomyelitis.Results： 16 cases in 18 flaps survived,and 2 cases with partial necrosis in distal part were cured after dressing.The cases were followed-up 2 to 12 months after the treatment,it is found that osteomyelitis was cured and flap outline was satisfied with no fat,no contracture;moreover,sensory recovery was satisfied.Further,two point sense discrimination was 3-6mm,and the functions of the thumb were good.Conclusions： The clinical efficiency of distally based thenar muscle composite flap in the repair of the severe soft tissue defects in the thumb or phalangeal osteomyelitis are satisfied.