带血管髂腹下神经移植在腹部带蒂皮瓣原位转移断指(掌)再植术后肢体功能恢复效果

Efficacy of Abdominal Nerve Transplantation with Vascular Iliac of Abdominal Pedicle Flap on Limb Function Recovery in Repairing Isolated Finger(Palm)

目的:探讨带血管髂腹下神经移植在腹部带蒂皮瓣原位转移断指(掌)再植术后肢体功能恢复效果。方法:选取2014年1月-2016年10月本院收治的断指(掌)患者24例,均采用带血管髂腹下神经移植在腹部带蒂皮瓣原位转移断指(掌)再植术治疗,术后进行随访,评估皮瓣存活情况、创面愈合时间、断指(掌)的骨骼生长情况及肢体功能。结果:患者均在急诊手术下给予断指(掌)再植术,皮瓣均存活,创面愈合时间14~28 d,平均(17.3±3.1)d;术后3个月,X线片检查1例断肢患者骨折不愈合,彻底清创后行二期骨瓣移植,骨折愈合;术后1年,患者肢体功能优8例(断指7例,断掌1例),良13例(断指7例,断掌6例),可2例(断指1例,断掌1例),差1例(断掌1例),总优良率87.50%,断指优良率93.33%,断掌优良率77.78%。结论:带血管髂腹下神经移植在腹部带蒂皮瓣原位转移断指(掌)再植术应用疗效满意,肢体功能恢复良好,值得应用。

Objective:To explore the efficacy of abdominal nerve transplantation with vascular iliac of abdominal pedicle flap on limb function recovery in repairing isolated finger(palm).Method:A total of 24 patients with isolated finger(palm)treated in our hospital from January 2014 to October 2016 were selected in this study.All patients were treated with abdominal nerve transplantation with vascular iliac of abdominal pedicle flap,follow up after operation,skin flap survival,wound healing time,isolated finger(palm)of the bone growth and limb functionwere evaluated.Result:All patients of isolated finger(palm)under the emergency surgery to give the finger(palm)replantation,all the flaps survived and the healing time was 14-28 d,average(17.3±3.1)d.After operation3 months,1 case of fracture were not healed by X-ray examination,and two stage bone graft was performed after complete debridement.Afteroperation1 year,excellent limb function was found in 8 cases(7 isolated fingers and 1 isolated palm),13 cases good(7 isolated fingers,6 isolated palm),2 cases fair(1 isolated finger,1 isolated palm)and 1 cases poor(isolated palm),the total excellent rate was 87.50%,the excellent and good rate of isolated finger was 93.33%,the excellent and good rate of isolated palm was 77.78%.Conclusion:The application of abdominal nerve transplantation with vascular iliac of abdominal pedicle flap intreatment of Isolated finger(palm)is satisfactory and the limb function is good,it’s worthy application.