掌背动脉皮支皮瓣修复多个手指软组织缺损

Repair of multi-fingers soft tissue defects with flaps based on cutaneous branches of dorsal metacarpal artery

目的 探讨应用掌背动脉皮支皮瓣修复多个手指软组织缺损的方法和效果. 方法 自2010年2月至2013年1月,对9例多个手指软组织缺损,采用第2、3、4掌背动脉皮支皮瓣修复,皮瓣切取面积为1.2cm×2.5cm-2.5 cm×5.0cm,供区全厚皮片植皮. 结果 术后皮瓣全部成活.术后随访8-24个月,平均12个月,皮瓣外形满意,质地优良,不臃肿,感觉恢复至S3-S3^＋,两点辨别觉10 - 13mm（平均11.6 mm）,手指屈伸功能按TAM法评价,达健侧手指的60％- 75％.供区植皮质地柔软. 结论 掌背动脉皮支皮瓣切取方便,血供可靠,不牺牲主干血管,是修复多个手指软组织缺损的良好方法.

Objective To investigate the method and result of repairing multi-fingers soft tissue defects using the dorsal metacarpal flaps with cutaneous branches as pedicle.Methods From February,2010 to January,2013,9 patients with multi-fingers tissue defects were treated with the 2nd,3rd,4th dorsal metacarpal flaps with cutaneous branches as pedicles.The area of flaps ranged from 1.2 cm × 2.5 cm to 2.5 cm × 5.0 cm.The donor sites were sutured with full thick skin graft.Results All flaps survived.After a followed-up of 8 months to 24 months（average 12 months）,the texture and shape of the flaps were good and non-bloated.The flap sensibility as sessment were S3-S3^＋.The two-point discrimination testing were 10 to 13 mm （average 11.6 mm）.The TAM score of range of motion was 60% to 75% of the healthy side.The skin graft of donor site were soft.Conclusion Procedure of dorsal metacarpal flaps with cutaneous branches as pedicles easy is a good method to repaire the soft tissue defects of muhi-fingers.