伤指背筋膜岛状皮瓣修复手指软组织缺损

Homodigital dorsal fascia island flap for repairing dorsal or palmer soft tissue defect of the injuried finger

目的介绍以伤指指背筋膜为蒂,带指固有神经背侧支的岛状皮瓣顺行或逆行转移修复指腹或指背软组织缺损的方法。方法在手指近、中节背侧沿指固有神经背侧支走行方向设计并切取筋膜蒂皮瓣,切取皮瓣时蒂部带一矩形皮瓣,以减轻转位后皮瓣蒂部的张力。皮瓣顺行转移不需缝合神经,逆行转移时与受区神经缝合。皮瓣切取范围不超过手指侧中线,切取面在腱周浅层,皮瓣转移轴线沿指固有神经背侧支走向。结果本组17例22指皮瓣全部成活。结论采用伤指指背筋膜蒂岛状皮瓣转移修复指腹或指背皮肤缺损是一种简单安全,行之有效的手术方法。

objective To introduce a method for repairing dorsal or palmer soft tissue defect of the injured finger by using homodigital anterogrde and reversed dorsal fascia island flap, which include the dorsal branch of the digital proper nerve. Methods The flap was designed at the dorsum of the middle and proximal phalanx along the dorsal branch of digital proper nerve, it contained a rectangular skin pedicle for reducing tension at the site of pedicle. Neurosuture was unnecessary in anterogrde flap, and in reversed flap, we sutured digital nerve with the dorsal branch nerve of flap.Results In the group, 22 flaps of 17 cases were all survived. Conclusion The homodigital dorsal fascia island flap is a simple, safe and effective method for reconstruction the soft tissue defect at the dorsum or palmer side of the injured finger.