以邻指动脉侧方皮瓣重建远端指节血运的临床应用

Clinical Application of Distal Finger with Flap from Lateral Side of the Artery of Proximate Finger

目的:寻求防止手指中段掌侧软组织缺损继发远端指节坏死的手术方法。方法:将邻指指动脉侧方皮瓣带蒂转位修复创面,以皮瓣血管游离端同患指远端指节的指动脉端端吻合重建患指血运。结果:此术式修复11例患者。其中10例经血管吻合后解除了远端指节血管危象,保留了手指长度和部发功能,1例因未吻合远端血管而出现远端指节坏死而截指。结论:手指中段掌侧严重组织缺损而伤及双侧指动脉,可在皮瓣修复创面的同时予以重建息指血运,以免发生迟发性血运障碍致远端指节坏死。邻指指动脉侧方皮瓣带蒂顺行转位桥接术可满足这些要求。

Objective:To search for an effective procedure to pretent distal digit necrosis due to sveere defect of middle digit. Methods:The pedicle vascular digital flap was harvested and its distal end was anastomosed with the distal digital artery of recipient finger to repair the defect and restore the distal blood supply. Results: The operation was performed on 11 cases of which 10 distal digital crisis of blood supply relieved and were the digiti length and part of the function preserved. However, in one case, the distal finger which didn' t anastomose with the flap's artery was amputated due to necrosis. Conclusion: Serious defect of middle part of digit may be companied witi damage of both digital arteries of the finger. So not only should the defect be repaired but also the blood supply be restored.The procedure can meet all these reo,uirements and prevend distal part necrosis.