以指蹼动脉为蒂的掌背动脉皮瓣的临床应用

Clinical application of dorsal metacarpal arterial flap with the pedicle of fingerweb artery

的 根据掌背动脉及皮支、指蹼动脉的解剖,探讨以指蹼动脉为蒂的掌背动脉皮瓣的手术方法及临床效果.方法 2013年1月-2015年5月,采用以指蹼动脉为蒂的掌背动脉皮瓣或肌腱皮瓣修复手指组织缺损平面位于近侧指间关节以远的患者36例41指.其中合并伸肌腱缺损5指,屈肌腱缺损2指.结果 术后4例皮瓣边缘出现张力性水疱,其余皮瓣创面均Ⅰ期愈合.供区切口创面均Ⅰ期愈合.术后31例35指获随访,随访时间6~14个月.皮瓣外观饱满,质软,皮色稍暗.两点辨别觉为6~10 mm.按TAM评分法评定,优良率为91.4%.结论 以指蹼动脉为蒂的掌背动脉皮瓣,延长了皮瓣的血管蒂,可携带伸肌腱移植、修复位于手指近指间关节已远的缺损创面,是修复手指皮肤软组织缺损或合并肌腱缺损的一种较好方法.

Objective According to the anatomy of dorsal metacarpal artery and fingerweb artery, to discuss the surgical method and clinical effect of dorsal metacarpal arterial flap on the basis of fingerweb artery. Methods A total of 36 patients （41 fingers） with finger tissue defect were treated with the modified retrograde palm dorsal artery flap or tendon flap. With stretch tendon defect in 5 fingers, flexor tendon defect in 2 fingers. Results In postoperative patients, flap edges occurred tension vesicle, color dark, scabbing in 4 cases, was cured after dressing change. The rest of the skin flap primary healed. For area incision at donor sites healed primarily. In 31 cases of postoperative （35 fingers ） refers to been followed up for 6~14 months. All flaps appearance was full, soft, though a little dark. Two distinguish sense for 6 ~ 10 mm. According to the TAM standards, the excellent and good rate was 91.4%. Conclusion On the basis of the dorsal metacarpal artery flap pedicled with webbed artery, extend the vascular pedicle skin flap, portable extensor tendon transplantation, restoration of the interphalangeal joint in finger near far defect wound, is and good method for repairing finger skin and soft tissure defect or merge tendon defect.