拇指桡侧逆行筋膜皮瓣修复拇指软组织缺损

Repair of the soft tissue defect of the thumb with a homodigital reversed radial fasciocutaneous flap

目的 介绍拇指桡侧逆行筋膜皮瓣修复拇指软组织缺损的手术方法。方法 1998年 8月至 1999年 12月 ,对 7例患者用拇指桡侧逆行筋膜皮瓣 ,分别修复拇指指腹、背侧及拇桡侧软组织缺损。皮瓣设计在拇指桡侧 ,以指侧正中线为轴线 ,其蒂部转折点在软组织缺损区以近 0 .5cm～ 1.0cm处。皮瓣面积最大 4.3cm× 3 .0cm ,最小 2 .5cm× 1.5cm。结果 7例的皮瓣全部成活 ,术后随访 5～ 8个月 ,外形美观 ,质地柔软 ,指腹二点分辨觉 (2 PD)为 7～ 12mm。结论 拇指桡侧逆行筋膜皮瓣具有操作简便、质地良好、血供可靠等优点 。

Objective To introduce a reversed fasciocutaneous flap of radial side of the thumb for the soft tissue defect of the thumb. Methods From August 1998 to December 1999, seven patients with the soft tissue defects of the thumb were treated with the reversed radial fasciocutaneous flaps. Axial line of the flap was in median line of radial side of the thumb. It is 0.5 mm to 1.0 mm between the pedicle and the soft tissue defect of the thumb. The largest size was 4.3 cm × 3.0 cm,the smallest was 2.5 cm × 1.5 cm.Results All flaps survived in 7 cases. They were followed up for 5 to 8 months. The color and texture of the flaps were nearly normal. Their near normal appearance and sensation with 2 PD of 7 ～ 12 mm were acceptable.Conclusions The homodigital reversed radial fasciocutaneous flap is a reliable flap with easy dissection and good texture in repair of the soft tissue loss of the thumb.