第1掌背动脉皮瓣一期修复儿童拇指软组织缺损

Clinical application of first dorsal metacarpal artery flap for repair of thumb tissue defect in emergency

目的探讨第1掌背动脉皮瓣一期顺行修复儿童拇指软组织缺损的临床效果。方法选取自2009-06—2012—06收治的拇指皮肤组织缺损息儿11例，行急诊清创、残端修整及伴肌腱断裂的修补，骨折患者给予克氏针内固定，11例均予一期第1掌背动脉皮瓣修复拇指组织缺损。结果术后组织瓣全部成活，供区、受区伤口均一期愈合，质地与色泽较好。随访时间为3。24个月，平均10个月，无继发性感染发生，感觉恢复S3一S4，肢体外形与功能满意。结论儿童拇指软组织缺损应用第1掌背动脉皮瓣移植修复、重建软组织，可以避免儿童患拇指功能障碍。采用该皮瓣技术血供可靠、操作简单，是一期修复儿童拇指皮肤缺损理想的治疗方法。

Objective To investigate the clinical effects of anterograde first dorsal metacarpal artery flap for repair pediatric thumb soft tissue defect. Methods Eleven eases of thumb soft tissue defect from June 2009 to June 2012 were treated. Emergency wound debridement was performed, thumb stump was trimmed, tendon rupture was repaired, fractures were treated with Kirschner wire, 11 eases of thumb soft tissue defect were repaired by the first dorsal metacarpal artery flap. Results Postoperative flap survived, the wound of donor area and recipient area healed, with better texture and color.Nine cases sural nerve nutrient vascular flap survived after transplantation, the wound healed, texture and color of flap were good.The follow-up was 3-24 months, with an average of 10 months, there was no secondary infection, sensory recovery for S3-$4. The limb overall and function were satisfactory. Conclusion The first dorsal metacarpal artery flap can be used for the pediatric thumb soft tissue defects and reconstruction of soft tissue. It can prevent children limb dysfunction. The flap has reliable blood supply, and operation is simple. It is an ideal treatment for repairing children＇s thumb skin defect.