正中神经掌皮支营养血管复合组织瓣临床应用

Repairing of soft tissue defect of thumb by neuromyocutaneous flap based on nutritional vessel of median nerve palmar cutaneous branch

目的：探讨正中神经掌皮支营养血管肌皮瓣转移修复拇指软组织缺损的临床疗效。方法应用正中神经掌皮支营养血管远端蒂肌皮瓣转移修复拇指软组织缺损12例。结果术后12例肌皮瓣全部成活。拇指外观及功能满意，10例在术后1周皮瓣两点分辨觉为6.4～8.7 mm。结论正中神经掌皮支营养血管链同拇短展肌和拇短屈肌肌皮穿支恒定吻合，该肌皮瓣是修复拇指软组织缺损的良好供区。

Objective To evaluate the clinical application of neuromyocutaneous flap based on nutritional vessel of median nerve palmar cutaneous branch for repairing soft tissue defect of the thumb. Methods Neummyocutaneous flap distally based on the nutritional vessel of median nerve palmar cutaneous branch was transferred to repair soft tissue defect of 10 thumbs. Results All of the 12 cases of neuromyocutaneous flap survived. The function and appearance of the thumbs were good. 1 week after the surgery, the average two-point discrimination at thumb pulp resurfaced by the flaps was 6.4～8.7 mm in 10 cases. Conclusion There exists constant anastomosis between the nutritional vessel chain of median nerve palmer cutaneous branch and the perforators of abductor pollicis brevis and flexor pollicis brevis. The nouromyocutarleous flap is a good option to repair soft tissue defect of thumb.