踇甲皮瓣游离移植治疗急诊拇指损伤的临床效果评价

Curative Effect of Free Wrap-round Flap on Severe Avulsion Injury of the Thumbs

目的探讨踇甲皮瓣游离移植对急诊拇指损伤的临床效果。方法收集急诊拇指损伤患者80例,以踇甲皮瓣游离移植修复,并以示指背侧岛状皮瓣、环指侧方岛状皮瓣修复拇指损伤40例为对照,术后根据皮瓣成活及随访情况进行评价。结果观察组有效率91.25%,对照组有效率85%,两组有效率比较差异有统计意义(Ridit=10.251,P=0.000);两组患者皮瓣感觉差异无统计学意义(P>0.05);皮瓣两点分辨觉观察组差于对照,差异具有统计学意义(P<0.05);对照组术后出现2例皮瓣有异位感,1例定位模糊。结论采用甲皮瓣游离移植对急诊拇指损伤进行修复,手术效果良好。

Objective To investigate the curative effect of the free wrap-round flap on severe avulsion injury of the thumbs. Method 80 cases with severe avulsion injury of the thumbs treated with free wrapround flaps were chosen as observation group. And 40 cases with severe avulsion injury of the thumbs treated with index finger dorsal island flaps and ring finger side quadrate island flaps were chosen as control. The flap surviving rate and follow-up status after operation was evaluated. Results The total effective rate of observation group and control group was 91. 25% and 85%,respectively. Significant difference was found between the effective rate of two groups（ Ridit = 10. 251,P = 0. 000）. There was no significance between flap feeling of two groups（ P〉0. 05）. The two-point distinguishing feeling of observation group was significantly lower than that of control group（ P〈0. 05）. 2 cases in control group was found flap ectopia feel,1 case showed obscure location. Conclusion It shows good curative effect of the free wrap-round flaps for the treatment of severe avulsion injury of the thumbs.