桡动脉掌浅支为蒂的嵌合骨皮瓣游离移植修复手指复合组织缺损

Reconstruction of digital composite defects via a free chimeric bone flap based on the superficial palmar branch of the radial artery

目的探讨以桡动脉掌浅支为蒂的嵌合骨皮瓣游离移植修复手指复合组织缺损的临床疗效。方法2013年7月至2016年1月,应用桡动脉掌浅支嵌合骨皮瓣游离转移修复手指复合组织缺损9例;手术中以桡动脉掌浅支为蒂切取皮瓣和骨瓣,皮瓣面积1.5cm×4.0cm^3.5cm×6.5cm,骨瓣大小0.5cm×1.0cm×1.5cm^1.0cm×2.5cm×3.5cm。术后定期随访。结果9例嵌合骨皮瓣均成活良好。骨瓣平均愈合时间1.6(1.5~3.0)个月,患指外观恢复良好,供区瘢痕轻微,术后6个月皮瓣两点辨别觉平均为6.6(5.3~8.6)mm,末次随访按中华医学会手外科学会上肢部分功能评定拇、手指再造功能评定试用标准评定患指功能:优7例,良1例,中1例。结论以桡动脉掌浅支为蒂的游离嵌合骨皮瓣可同时修复软组织和骨缺损,有利于缩短病程,加快患指功能恢复,是修复手指复合组织缺损的一种新选择。

ObjectiveTo explore the clinical effect of free chimeric bone flap based on the superficial palmar branch of radial artery to repair finger composite tissue defects. MethodsFrom July, 2013 to January, 2016, 9 cases of finger composite tissue defect were repaired by free chimeric bone flap from the wrist crease area. The flap and bone flap were taken with the superficial palmar branch of the radial artery during the operation. The area of the flap was 1.5 cm × 4.0 cm to 3.5 cm× 6.5 cm, and the size of the bone flaps were 0.5 cm × 1.0 cm × 1.5 cm to 1.0 cm × 2.5 cm × 3.5 cm. Regular followed-up was done after the operation. ResultsNine cases of chimeric bone flap survived well, and the average healing time of bone flap was 1.6(1.5-3.0) months. The function and appearance of the patients recovered well. The scars on the donor area was slight. The average two-point discrimination of flap was 6.6(5.3 to 8.6) mm at 6 months after operation. According to the Evaluation Criteria of Thumb and Finger Reconstructive Function Assessment of the Upper Limb of the Chinese Medical Association, 7 cases were superior, 1 was good, 1 was medium. ConclusionThe free chimeric bone flap pedicled with superficial palmar branch of radial artery can simultaneously repair soft tissue and bone defects. It helps shorten the course of disease and speed up the recovery of finger function. It is a new choice to repair finger tissue defects.