中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2010年
2期
95-97,后插三
,共4页
邵新中%朱禝兴%吕莉%喻伟光%贾晓川
邵新中%硃禝興%呂莉%喻偉光%賈曉川
소신중%주직흥%려리%유위광%가효천
虎口挛缩%髂腹股沟皮瓣%桡动脉上行穿支皮瓣%显微外科手术
虎口攣縮%髂腹股溝皮瓣%橈動脈上行穿支皮瓣%顯微外科手術
호구련축%가복고구피판%뇨동맥상행천지피판%현미외과수술
Contracture of the first web space%Groin flap%Stylus recurrent branch of radial artery flap%Microsurgical operation
目的 探讨髂腹股沟皮瓣与桡动脉鼻烟窝上行穿支逆行皮瓣治疗重度虎口挛缩的手术疗效.方法 2007年3月至2009年6月,采用髂腹股沟皮瓣和桡动脉鼻烟窝上行穿支逆行皮瓣治疗虎口重度挛缩45例,其中采用髂腹股沟皮瓣治疗33例,采用桡动脉鼻烟窝上行穿支逆行皮瓣治疗12例,开大虎口同时行拇外展功能重建21例,术后进行6～12个月随访.结果 除3例选择桡动脉鼻烟窝上行穿支逆行皮瓣患者和1例选择髂腹股沟皮瓣患者皮瓣远端出现远端浅表坏死,其余患者皮瓣均一期愈合,虎口开大距离均可达健侧虎口90%以上.术后随访患者对掌功能恢复良好,髂腹股沟皮瓣稍臃肿,部分出现轻度色素沉着,其余皮瓣颜色均与手部皮肤相近.结论 对儿童、青少年及50岁以下成人病例开大虎口宜首选髂腹股沟皮瓣修复,对50岁以上成人及老年病例宜首选桡动脉鼻烟窝上行穿支逆行皮瓣修复.
目的 探討髂腹股溝皮瓣與橈動脈鼻煙窩上行穿支逆行皮瓣治療重度虎口攣縮的手術療效.方法 2007年3月至2009年6月,採用髂腹股溝皮瓣和橈動脈鼻煙窩上行穿支逆行皮瓣治療虎口重度攣縮45例,其中採用髂腹股溝皮瓣治療33例,採用橈動脈鼻煙窩上行穿支逆行皮瓣治療12例,開大虎口同時行拇外展功能重建21例,術後進行6～12箇月隨訪.結果 除3例選擇橈動脈鼻煙窩上行穿支逆行皮瓣患者和1例選擇髂腹股溝皮瓣患者皮瓣遠耑齣現遠耑淺錶壞死,其餘患者皮瓣均一期愈閤,虎口開大距離均可達健側虎口90%以上.術後隨訪患者對掌功能恢複良好,髂腹股溝皮瓣稍臃腫,部分齣現輕度色素沉著,其餘皮瓣顏色均與手部皮膚相近.結論 對兒童、青少年及50歲以下成人病例開大虎口宜首選髂腹股溝皮瓣脩複,對50歲以上成人及老年病例宜首選橈動脈鼻煙窩上行穿支逆行皮瓣脩複.
목적 탐토가복고구피판여뇨동맥비연와상행천지역행피판치료중도호구련축적수술료효.방법 2007년3월지2009년6월,채용가복고구피판화뇨동맥비연와상행천지역행피판치료호구중도련축45례,기중채용가복고구피판치료33례,채용뇨동맥비연와상행천지역행피판치료12례,개대호구동시행무외전공능중건21례,술후진행6～12개월수방.결과 제3례선택뇨동맥비연와상행천지역행피판환자화1례선택가복고구피판환자피판원단출현원단천표배사,기여환자피판균일기유합,호구개대거리균가체건측호구90%이상.술후수방환자대장공능회복량호,가복고구피판초옹종,부분출현경도색소침착,기여피판안색균여수부피부상근.결론 대인동、청소년급50세이하성인병례개대호구의수선가복고구피판수복,대50세이상성인급노년병례의수선뇨동맥비연와상행천지역행피판수복.
Objective To investigate the methods and the therapeutic effects of groin flap and stylus recurrent branch of radial artery flap for the repair of severely contracture of the first web space. Methods From March 2007 to six 2009,45 patients with severely contracture of the first web space received treatment of groin flaps and stylus recurrent branch of radial artery flaps, with 6 to 12 months clinical observation. Among then, 33 patients received treatment of groin flaps, 12 patients received treatment of stylus recurrent branch of radial artery flaps, and 28 patients received the first web space widening as well as functional reconstruction of thumb abduction. Results Most of the flaps healed by first intention but also with distal necrosis for 3 stylus recurrent branch of radial artery flaps and 1 groin flap. And the weth of the first web space of all patients were more than 90% of comparison. From clinical observation,function of opposition recovered well. While some groinflaps got a litte fat and clumsy .The color of most flaps was as similar as normal besides, some groin flaps occurrenced pigmentation. Conclusion Children and adults below 50 yesrs should choose the groin flap, and aged people and adults more than 50yesrs shuould choose the stylus recurrent branch of radial artery flap firstly.
