前臂骨间背侧穿支皮瓣逆行修复烧伤后重度虎口挛缩畸形

Application of the Forearm Reverse Interosseous Perforator Flap for Repairing the Severe Contracture of Thumb Web after Burn

目的:探讨前臂骨间背侧皮瓣修复烧伤后重度虎口挛缩畸形的临床效果。方法:16例烧伤后的重度虎口挛缩患者,手术松解虎口后,软组织缺损范围为3cm×6cm^5cm×8cm,采用大小为4cm×6cm^6cm×9cm的前臂骨间背侧穿支皮瓣逆行修复缺损,供瓣区植皮修复。结果:16例皮瓣全部成活,切口均一期愈合,6例行二期皮瓣削薄术。术后随访6~14个月,平均10.5个月,皮瓣感觉恢复:S2 4例,S3 9例,S3+3例;功能恢复:优13例,良2例,中1例,优良率93.75%。结论:应用前臂骨间背侧穿支皮瓣是修复重度虎口挛缩的有效手术方法,具有并发症少、修复质量高、功能恢复良好等优点。

Objective To investigate the clinical effect of forearm reverse interosseous perforator flap for repairing the severe contracture of thumb web after burn. Methods 16 patients with the severe contracture of thumb web after burn, who were treated with surgical release of the thumb web. And the defect area was 3 cm×6 cm-5 cm×8 cm. The forearm reverse interosseous perforator flaps with 4 cm×6 cm-6 cm×9 cm were used to repair the defect area of thumb web, and the donor sites of flaps received skin-grafting. Results All 16 flaps survived, the incision healed at first intention, and 6 cases underwent two stage skin flap thinning. The postoperative follow-up was 6-14 months, with an average of 10.5 months, the sensation of the flaps returned to S2 four cases, S3 nine cases, S3＋ three cases. In addition, the functional recovery of flaps： excellent in 13 cases, good in 2 cases, and fair in 1 cases, and the good effect rate was 93.75%. Conclusion The application of forearm reverse interosseous perforator flap is an effective method for repairing the severe contracture of thumb web after burn. This method has the advantages of less complications, a good performance of tissue repairing and functional recovery.