中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2010年
4期
278-280,后插三
,共4页
陆俭军%谭海涛%江建中%罗翔%韦平欧%林汉%邓贵全
陸儉軍%譚海濤%江建中%囉翔%韋平歐%林漢%鄧貴全
륙검군%담해도%강건중%라상%위평구%림한%산귀전
指%第二足趾%皮瓣%显微外科
指%第二足趾%皮瓣%顯微外科
지%제이족지%피판%현미외과
Finger%Second toe%Flap%Microsurgery
目的 探讨应用第二足趾腹皮瓣游离移植修复拇、手指指腹软组织缺损的手术方法和临床疗效.方法 根据拇、手指指腹软组织缺损的大小、范围和形状,于同侧第二足趾胫侧趾腹设计趾腹皮瓣,皮瓣的轴线为第二足趾胫侧趾底固有动脉、神经的投影.切取皮瓣面积2.0 cm×2.3 cm～2.0 cm×3.5 cm,临床应用修复10例.结果 术后有2例皮瓣边缘少部分坏死,经换药后创面愈合外,另8例皮瓣均成活良好.术后随访4～16个月,皮瓣血运、质地、弹性良好,指腹饱满,外形满意.手指功能恢复良好.皮瓣两点分辨觉为5.0～9.0 mm.第二趾供区创面均Ⅰ期愈合,不影响穿鞋及行走.结论 游离第二足趾胫侧趾腹皮瓣手术简便,血供可靠,可重建感觉功能,是修复拇、手指指腹软组织缺损的良好方法.
目的 探討應用第二足趾腹皮瓣遊離移植脩複拇、手指指腹軟組織缺損的手術方法和臨床療效.方法 根據拇、手指指腹軟組織缺損的大小、範圍和形狀,于同側第二足趾脛側趾腹設計趾腹皮瓣,皮瓣的軸線為第二足趾脛側趾底固有動脈、神經的投影.切取皮瓣麵積2.0 cm×2.3 cm～2.0 cm×3.5 cm,臨床應用脩複10例.結果 術後有2例皮瓣邊緣少部分壞死,經換藥後創麵愈閤外,另8例皮瓣均成活良好.術後隨訪4～16箇月,皮瓣血運、質地、彈性良好,指腹飽滿,外形滿意.手指功能恢複良好.皮瓣兩點分辨覺為5.0～9.0 mm.第二趾供區創麵均Ⅰ期愈閤,不影響穿鞋及行走.結論 遊離第二足趾脛側趾腹皮瓣手術簡便,血供可靠,可重建感覺功能,是脩複拇、手指指腹軟組織缺損的良好方法.
목적 탐토응용제이족지복피판유리이식수복무、수지지복연조직결손적수술방법화림상료효.방법 근거무、수지지복연조직결손적대소、범위화형상,우동측제이족지경측지복설계지복피판,피판적축선위제이족지경측지저고유동맥、신경적투영.절취피판면적2.0 cm×2.3 cm～2.0 cm×3.5 cm,림상응용수복10례.결과 술후유2례피판변연소부분배사,경환약후창면유합외,령8례피판균성활량호.술후수방4～16개월,피판혈운、질지、탄성량호,지복포만,외형만의.수지공능회복량호.피판량점분변각위5.0～9.0 mm.제이지공구창면균Ⅰ기유합,불영향천혜급행주.결론 유리제이족지경측지복피판수술간편,혈공가고,가중건감각공능,시수복무、수지지복연조직결손적량호방법.
Objective To discuss the surgery procedure and treatment effect of reconstruction of the soft tissue of the thumb/finger defects by the second toe tibial toe pulp skin flap. Methods Ten patients with the soft tissue of pulp of the thumb/finger defects were treat by the same side of the second toe tibial toe pulp skin flap, all the patients have the soft tissue defect of finger pulp with exposed phalanx. Crush them in 4 cases, the machine cut wound in 6 cases. A fixed 2 cases, delayed operation 3-7d after injury to repair in 8 patients. The side of skin flap varied from 2.0 cm × 2.2 cm to 2.0 cm × 3.5 cm. Results Ten fingers in 10 cases all survived. Necrosis in edge part of the shin graft occurred in 2 cases, which was healed through changing of dressing. All cases were followed form 4 months to 16 months. The blood-supply, texture and elasticity of transferred flaps and the shape of fingers pulp were excellent. Good function recovery of the fingers was achieved. Pain and temperature sence were regained. Two point discrimination of the finger pulp was 5-9 mm.Primary healing occurred in all cases. It did not disturb dressing shoes and walking. Conclusion It is a reliable approach for soft-tissue coverage of the thumb/finger using the second toe tibial toe pulp skin flap based on distal perforators of digital artery or ulnar artery. The advantages include simply procedures, reliable blood supply without sacrificing main aneries and possibilities of sensoly recovery.
