食指背侧皮瓣与拇指背神经营养皮瓣修复拇指远节软组织缺损的效果比较

Dorsal thumb flap versus thumb dorsal nerve nutrient flap in repairing soft tissue defect of thumb distal segment

目的比较食指背侧皮瓣与拇指背神经营养皮瓣修复拇指远节软组织缺损的效果。方法回顾性分析42例拇指远节软组织缺损患者的临床资料,其中行食指背侧皮瓣修复术的20例患者为食指背组,行拇指背神经营养皮瓣修复术的22例患者为拇指背组。比较2组手术时间、术中失血量、皮瓣存活情况;随访1年,比较2组患者拇指恢复情况、皮瓣外观质地、皮瓣感觉恢复情况。结果 2组手术时间与术中失血量无显著差异(P>0.05)。2组皮瓣均全部存活,2组拇指恢复、皮瓣外观质地的优良率比较无显著差异(P>0.05),食指背组皮瓣感觉恢复的优良率为100.00%,显著高于拇指背组的72.73%(P<0.05)。结论食指背侧皮瓣与拇指背神经营养皮瓣在拇指远节软组织缺损修复的手术时间、失血量、拇指恢复情况、皮瓣外观质地方面的效果相当,但食指背侧皮瓣对于皮瓣感觉恢复的效果更为理想。

Objective To compare the effect of dorsal digital flap of the index finger and the thumb dorsal nerve nutrient flap in repairing the distal segment soft tissue defect of thumb. Methods The clinical data of 42 cases with distal soft tissue defect of thumb in our hospital were retrospectively analyzed, among whom 20 cases with dorsal index dorsal flap repair were selected as dorsal index of the index finger group and 22 cases with thumb dorsal neurocutaneous flap repair as thumb back group. All the patients were followed by one year, and the thumb recovery, skin texture and recovery of skin flap feeling of the two groups were compared. Results There was no significant difference in operative time and blood loss between the two groups （ P 〉0.05）. All of the flaps survived, and there were no significant differences between the two groups in thumb recovery and the excellence rate of appearance and texture of the skin flap （ P 〉0.05）, and the good rate of sensory recovery in the back of the index finger group was 100%, which was higher than that of the thumb back group （ P 〈0.05） . Conclusion Dorsal index dorsal flap repair and thumb dorsal neurocutaneous flap repair have the same efficacy in time of operation, the amount of blood loss, the recovery of the thumb and the appearance and texture of the skin flap, but the effect of the dorsal flap of the index finger has better sensory recovery of the skin flap.