逆行指背筋膜皮瓣修复指端缺损的感觉恢复评价

Evaluate sensory recovery with reverse dorsal digital fascia flap repairing fingertip defect

目的:比较逆行指背筋膜皮瓣修复指端缺损吻合神经和不吻合神经两种方法的感觉恢复。方法:应用逆行指背筋膜皮瓣修复指端缺损,根据入院顺序,针对指端缺损指进行数字排序,奇数指吻合皮瓣内皮神经和受区指神经,偶数指不吻合神经,分别手术18指,术后1、2、3、6、9、12月检测两组皮瓣两点辨别觉。结果:术后皮瓣全部成活,随访12月,吻合神经组感觉恢复在术后半年内优于未吻合神经组,术后9月时两组感觉无明显差别,但仍未达正常水平,术后1年感觉接近正常。结论:吻合神经对于修复指端缺损的筋膜皮瓣感觉的早期恢复有所帮助,远期效果上吻合神经与否影响不大。

Objective To evaluate sensory recovery with reverse dorsal digital fascia flap repairing fingertip defect by nerve anastomosis or no. Methods The fingertip defect was repaired with reverse dorsal digital fascia flap. According to the order of admission, the defecting fingers were digitally arranged.Odd fingers were repaired by anastomosing nerve in flap and in finger. Even fingers were repaired with no nerve anastomosis. Two groups were made up of 18 cases respectively. The twopoint discrimination of flap was checked in all cases when 1,2,3,6,9,12 months after surgery.Results All flaps survived, were followed up for 12 months.The sensory recovery of nerve anastomosis group was better than that of no nerve anastomosis group within six months after surgery. At 9th month after surgery it appeared no significant difference between the two groups, but it did not reach normal level. After 1 year the feeling of both was close to normal. Conclusion Nerve anastomosis for repairing fingertip defect with the fascia flap is helpful to early sensory recovery. But long-term effect is of no difference between nerve anastomosis and no.