急诊修复拇指指腹缺损三种方法的研究

Clinical study in emergency coverage of thumb pulp defect by three procedures

目的 报道采用不同方法急诊修复拇指指腹缺损的疗效。方法 采用示指背侧岛状皮瓣、拇指桡侧指动脉逆行岛状皮瓣转位及趾腹皮瓣游离移植三种方法 ,为 2 1例拇指指腹缺损进行急诊修复。结果 2 0例皮瓣成活 ,1例失败。术后随访半年～ 2年 ,平均 1 0个月。所有皮瓣血运、弹性、质地均良好。指腹二点分辨觉 :示指背侧岛状皮瓣平均为 9.2mm ,拇指桡侧指动脉逆行岛状皮瓣平均为 8mm ,趾腹皮瓣平均为 5.6mm。结论 急诊修复拇指指腹缺损首选趾腹皮瓣 。

Objective To report the treatment outcome of emergency coverage of thumb pulp defect by transfer of three kinds of flaps.Methods Twenty one cases with thumb pulp defects were repaired by transfer of 3 different flaps: pedicled dorsal island flap of index finger, the reverse island flap with a pedicle of the thumb radial artery, and free transplantation of toe pulp flap. Results All of the flaps survived except partial necrosis in 1 case. Over a period of 6 24 months follow up (average 10 months), the blood supply, elasticity and texture of flap were satisfactory. An average of the two point discrimination was 9 .2mm in pedicled dorsal island flap of index finger, 8 mm in the reverse island flap with a pedicle of the radial artery of thumb, and 5.6 mm in free transplantation of toe pulp flap.Conclusions Free transplantation of the toe pulp flap was of choice in emergency repair of thumb pulp defect if possible, and pedicled dorsal island flap of index finger, the reverse island flap with a pedicle of the radial artery of thumb can also be alternatively applied.