指背逆行岛状皮瓣修复指端软组织缺损

Dorsal digital retrograde island flap for repairing the defect of soft tissue

目的探讨指背逆行岛状皮瓣修复指端软组织缺损的手术方法及疗效。方法 2010年1月~2015年4月,应用指背逆行岛状皮瓣修复指端软组织缺损41例45指,其中男性32例,女性9例;年龄17~57岁,平均37岁。41例患者45指均有指骨外露,缺损面积1.8cm×1.5cm^3.0cm×2.5cm。皮瓣切取范围2.0cm×1.8cm^3.2cm×2.8cm。皮瓣旋转点于远指间关节以近,逆行旋转覆盖指端缺损区。结果 45指皮瓣均成活。39指随访5~20个月,平均12.5个月,皮瓣颜色、皮肤质地及弹性良好,外形佳,皮瓣两点辨别觉为8~10mm,皮瓣供区外观满意,手指运动功能满意。结论指背逆行岛状皮瓣手术操作简单,不伤及指间动脉及神经,血管蒂长,皮瓣蒂携带皮条,旋转弧度大,成功率高,疗效满意,是修复指端软组织缺损的有效方法之一。

Objective To investigate the surgical methods and efficacy of the dorsal reverse digital island flap in repairing soft tissue defects of fingertip. Methods From Jan. 2010 to Apr. 2015,45 fingers of 41 cases with soft tissue defects of fingertip and digital bone exposure were treated with dorsal reverse digital island flap. There were 32 males and 9 females,with an average of 37 years（ age ranged from 17 to 57 years）. The size of the defects ranged from 1.8cm× 1.5cm to 3.0 cm × 2. 5cm. The flaps ranging from 2. 0 cm × 1.8cm to 3.2cm × 2. 8cm.were reversed to repair the fingertip defects, and the rotation point was proximal to the phalangeal joints. Results All cases survived completely. After a follow-up ranging from 5 to 20 months with an average of 12. 5 months,39 fingers after reconstruction had satisfactory appearances and functions. The color, elasticity and texture of flaps were excellent ,and the donor sites had satisfactory appearance. The two point discrimination of the flap was 8-10ram. Conclu- sion Reverse digital island flap is one of the effective methods to repair the defect of fingertip soft tissue with many advantages such as simple operative procedure, no hurting the interphalangeal artery and nerve, long vascular pedicle,large rotation angle in radians, high success rate and atisfactory curative effect.