指动脉中节背侧穿支皮瓣修复手指皮肤软组织缺损

Clinical application of digital artery perforator flaps of dorsal middle phalanx for repairment of finger skin defects

目的 探讨应用指固有动脉中节背侧主干血管穿支与远节支形成的“兀”形血管网,设计指动脉中节中段背侧逆行或顺行血管穿支皮瓣修复手指缺损的临床疗效.方法 2012年8月-2014年9月,分别以手指中节指固有动脉的中段背侧支为蒂,逆行或顺行切取2-5指中节指背皮瓣修复位于近节指背、远节指腹指端皮肤缺损22例,皮瓣最大切取面积1.5 cm×3.0 cm.结果 术后随访3-18个月,皮瓣全部成活,皮瓣两点辨别觉6-9 mm,所累及关节功能恢复良好.结论 该皮瓣具有操作相对简单、不损伤指固有动脉及指神经、成功率较高等优点,是修复手指近节指背、末节指端、指腹皮肤缺损较为理想的手术方法.

Objective To design the digital artery retrograde or antegrade perforator flap of middle phalanx useing “π”shape vasoganglion of dorsal main perforators in middle phalanx of digital proper arteries and distal phalanx branch. Methods Dorsal branches of middle phalange digital artery were choosen as the pedicle, 2-5 finger middle phalanx dorsal skin flaps ware cut retrograde or antegrade, 22 cases with skin defects of digital dorsal defect of proximal interphalangeal joints and pulp skin defect of distal phalange were repaired, and the biggest cuting area of flaps were 1.5 cm×3.0 cm. Results Follow up for 3-18 months, all flaps survived. The two-point discrimination distance were 6-9 mm, joints functions were excellent. Conclusion The flap has advantages of relatively simple operation with a high success rate without artery and nerve damage. It was an ideal operation method for repairing the digital dorsal defect of proximal interphalangeal joints and finger tip and pulp defect of distal phalange.