CAJ | 학술논문

目的探讨上臂远端外侧肱骨骨皮瓣在手外科的临床应用效果.方法对8例手部复合组织缺损的患者,根据掌指骨缺损的情况,先设计骨瓣的切取位置和大小(骨瓣远端止于肱骨外上髁的上缘),然后再根据皮肤缺损的面积和骨缺损的相对位置设计皮瓣的大小.前臂后皮神经位于皮瓣的中轴线上,可以保留或一并切取使用,恢复受区感觉.皮瓣切取面积为4.0cm×8.0cm～6.0cm×8.0cm,骨瓣切取大小为4.0cm×1.5cm×1.0cm～6.0cm×1.5cm×1.0cm.结果术后8例骨皮瓣全部存活,上臂供区创面直接闭合,愈合好,上臂功能无影响.术后随访4～24个月,皮瓣感觉恢复良好,移植骨完全愈合,手部外形满意.结论上臂远端外侧肱骨骨皮瓣是修复手部创面和掌、指骨复合组织缺损的理想选择.
목적 탐토상비원단외측굉골골피판재수외과적림상응용효과.방법 대8례수부복합조직결손적환자,근거장지골결손적정황,선설계골판적절취위치화대소(골판원단지우굉골외상과적상연),연후재근거피부결손적면적화골결손적상대위치설계피판적대소.전비후피신경위우피판적중축선상,가이보류혹일병절취사용,회복수구감각.피판절취면적위4.0cm×8.0cm～6.0cm×8.0cm,골판절취대소위4.0cm×1.5cm×1.0cm～6.0cm×1.5cm×1.0cm.결과 술후8례골피판전부존활,상비공구창면직접폐합,유합호,상비공능무영향.술후수방4～24개월,피판감각회복량호,이식골완전유합,수부외형만의.결론 상비원단외측굉골골피판시수복수부창면화장、지골복합조직결손적이상선택.
Objective To investigate the clinical effect of the application of humeral osteocutaneous lateral arm flap in reconstruction of complex tissue defects of the hand. Methods Eight cases of complex tissue defects of the hand were treated. The location and size of the bone flap was designed first according to the defect of the metacarpal and phalangeal bones (the distal end of the bone flap was at the upper margin of the lateral epicondyle). Then the location and size of the cutaneous flap was designed according to the defects of the hand. The line between the insertion of deltoid muscle and the epicondylus lateralis humeri is the body projection of the posterior branch of radial collateral artery. It is the axis while designing the flap. The posterior antebrachial cutaneous nerve can be retained in the flap in order to restore sensation of the recipient site. The area of the skin flaps ranged from 4.0 cm× 8.0 cm to 6.0 cm× 8.0 cm, while the area of the bone flaps ranged from 4.0 cm× 1.5cm×1.0cm to 6.0cm×1.5cm×1.0cm. Results All 8 osteocutaneous flap survived uneventfully.The donor sites were closed directly in all 8 cases. Functions of the upper arm were not impaired. The patients were follow-up for 4 to 24 months. Flap sensation recovery was satisfactory. Bone healing was observed and hand appearance was satisfactory. Conclusion The humeral osteocutaneous lateral arm flap is ideal for reconstruction of complex tissue defects of the hand.