长蒂指固有动脉中段背侧支岛状皮瓣修复间隔指指腹缺损

Interval finger island flap with long pedicle of dorsal branch in the middle section of the internal artery repairing defect of finger pulp

目的探讨长蒂指固有动脉中段背侧支岛状皮瓣修复间隔指指腹缺损的方法及临床疗效。方法对41例不能应用邻指皮瓣修复的指腹缺损患者采用长蒂指固有动脉中段背侧支岛状皮瓣修复。根据伤指皮肤缺损形状和面积在间隔手指中节背侧设计指固有动脉中段背侧支长蒂岛状皮瓣,皮瓣设计面积为1.5 cm×1.2 cm^2.5 cm×1.5 cm。供区全厚皮片游离移植。采用中华医学会手外科学会上肢部分功能评定试用标准评价疗效。结果皮瓣全部顺利成活,术后2~3周顺利断蒂。41例均获得随访,时间5~28个月。患指皮瓣外形良好,无瘢痕挛缩畸形,皮瓣感觉恢复良好,两点辨别觉4~11 mm,功能恢复良好。末次随访时参照中华医学会手外科学会上肢部分功能评定试用标准评价疗效:优38例,良2例,差1例,优良率97.6%。结论采用长蒂指固有动脉中段背侧支岛状皮瓣修复间隔指指腹缺损,血运可靠,方法简单,疗效确切。

Objective To investigate the method and the therapeutic effect of the interval finger island flap with long pedicle of dorsal branch in the middle section of the internal artery in repairing defect of interval finger pulp.Methods The 41 patients with finger pulp defects who could not be repaired with adjacent finger flap were repaired by using the island flap with long pedicle of dorsal branch in the middle section of the internal artery.According to the shape and area of the skin defect of the finger,the island flap with long pedicle was designed on middle section of the interval finger.The size of flaps ranged from 1.5 cm×1.2 cm^2.5 cm×1.5 cm.The donor site was closed by full thickness skin free graft.The upper limb function evaluation tentative criteria by Society of Hand Surgury of Chinese Medical Association was used to evaluate the effect.Results All the skin flaps were alive after operation.After 2~3 weeks,the pedicle was cut successfully.All patients were followed up for 5~28 months.All the follow-up patients’flaps were good in shape and had no dysmorphia of scar contracture.The dialy neurg flap sensation and function got right.The two points discrimination was 4~11 mm.According to the upper limb function evaluation tentative criteria by Society of Hand Surgury of Chinese Medical Association,the results were excellent in 38 cases,good 2 cases,and poor in 1,and the excellent and good rate was 97.6%.Conclusions Using interval finger island flap to repair the defect of finger pulp has the advantages of blood supply safety,easy method,and good shape and function of the injured finger after operation.