邻指指动脉Flow-through皮瓣桥接断指血运的临床应用

One-staged coverage and revascularisation of traumatised fingers by neighboring digital artery flow-through flaps

目的探讨邻指指动脉Flow-through皮瓣桥接断指血运的临床应用价值. 方法 2008年5月至2010年7月,对7例外伤所致手指不全离断伤合并皮肤缺损的病例,一期手术采用邻指指动脉Flow-throug 皮瓣桥接断指血运.术后问卷调查患者对皮瓣外形满意度（％）,检测皮瓣痛触觉、温度觉、两点辨别觉（mm）,检测患指关节活动. 结果 7例皮瓣及断指均存活良好,供区植皮存活良好.随访1～3年,皮瓣具有良好的质地和外形,患者对皮瓣外形均满意（100％）.术后12个月,断指两点瓣别党为6.1～9.6 mm,平均为（7 1±177;1.3） mm;皮瓣感觉神经功能评级为S3＋级；断指及供指关节活动度（TAM）比值（患侧/健侧）恢复至0.81±177;0.16. 结论 邻指指动脉皮瓣是一种良好的Flow-through皮瓣术式,是成功挽救伴有皮肤缺损的断指的一种较好方法.

Objective To investigate the clinical application of neighboring digital artery flow-through flaps for one-staged skin coverage and revascularisation after severe finger injuries.Methods From May 2008 to July 2010,there were ischemic fingers had severe injuries,aged 19 to 52 years old,which were male in 5 cases,female in 2 cases,with skin and arterier defected.One-staged coverage and revascularisation of traumatised fingers were used with neighboring digital artery flow-through flaps.Functional exercise and physical therapy were done 3 weeks later.All cases had more than 12 months＆#39; fellowed-up periods.The sensibility testing,Questionnaire of the flap aesthetic satisfactory and TAM evaluations were all performed in all patients.All the results were measured and evaluated.Results All flaps survived completely and digit blood circulations were good in 7 patients.The flaps had good appearance and aesthetic satisfactory （100%）.At 12 months after operations,the pain and touch perception reinnervated until 6 months and two-point discrimination testing were 6.1 to 9.6 mm,mean was （7.1 ＆#177; 1.3） mm,and the flap sensibility assessment were S3 ＊ and TAM evaluation ratio were 0.81 ＆#177;0.16.Conclution Neighboring digital artery flap ideally suited as a thin and pliable flow-through flap in digital replantation/revascularization.It is helpful for salvage of the ischemic fingers after injury with skin and arteries defects.