CAJ | 학술논문

目的：研究同指螺旋皮瓣修复指端指腹缺损的临床疗效。方法：回顾性分析2010年1月~2012年9月在江门市人民医院骨科行同指螺旋皮瓣修复指端指腹缺损手术的患者资料，共22例27指。采用拍照和问卷调查的方式来评估术后情况。评价指标包括伤口愈合及美观程度评价，手指功能恢复情况，重返工作岗位的时间，关节运动情况，两点辨别觉等。结果：男性16例(72.7％)，女性6例(27.3％)。年龄(33.4±13.1)岁。皮瓣及移植皮片全部存活(成功率为100％)，无需要二次手术的患者，无皮瓣充血、血肿、感染等围手术期并发症。缺损面积最大为2.5 cm×3 cm，最小为1.0 cm×1.5 cm，均伴有骨、肌腱外露。术后应用抗生素(3.5±2.8) d。随访时间(22.5±10.3)月。患者回到原工作岗位时间(6.9±2.3)周。感觉功能恢复好，两点辨别觉平均值为6.3 mm(5~7 mm)。没有一例出现不耐寒冷和超敏反应。结论：同指螺旋皮瓣修复指端指腹缺损临床疗效好，患者满意，适应在临床上广泛推广。
목적：연구동지라선피판수복지단지복결손적림상료효。방법：회고성분석2010년1월~2012년9월재강문시인민의원골과행동지라선피판수복지단지복결손수술적환자자료，공22례27지。채용박조화문권조사적방식래평고술후정황。평개지표포괄상구유합급미관정도평개，수지공능회복정황，중반공작강위적시간，관절운동정황，량점변별각등。결과：남성16례(72.7％)，녀성6례(27.3％)。년령(33.4±13.1)세。피판급이식피편전부존활(성공솔위100％)，무수요이차수술적환자，무피판충혈、혈종、감염등위수술기병발증。결손면적최대위2.5 cm×3 cm，최소위1.0 cm×1.5 cm，균반유골、기건외로。술후응용항생소(3.5±2.8) d。수방시간(22.5±10.3)월。환자회도원공작강위시간(6.9±2.3)주。감각공능회복호，량점변별각평균치위6.3 mm(5~7 mm)。몰유일례출현불내한랭화초민반응。결론：동지라선피판수복지단지복결손림상료효호，환자만의，괄응재림상상엄범추엄。
Objective:To describe a homodigital neurovascular island flag for reconstructing pulp defects of the fingertips and review the short-term appearance and function of the reconstructed fingertips. Methods:A total of 22 collected cases from Jan. 2010 to Sep.2012 were analyzed. Photos were taken and visual analog scale were used to evaluate the postoperative situation. Viability, wound healing, complications, time taken to return to work, joint motion, 2-point discrimination were assessed in this group. Results:In 22 patients, 27 fingers, 27. 3% was femail and 72.7% was male. The mean age was 33.4 years old. All flaps and skin grafts survived, and primary healing was achieved. No secondary procedures were required. There were no perioperative complications such as flap congestion, hematoma, or infection. The maximum size of the defect was 2.5cm wide× 3.0cm long and the minimum was 1.0cm wide×1.5cm long. All of the fingertips had bone and tendon exposed, with postoperative use of antibiotics for 3.5 days on average. The mean follow-up period was 22.3 months. All patients returned to their original job an average of 6.9 weeks postoperatively. Sensory recovery was excellent, with an average 2-point discrimination of 6.3 mm. There was no cold intolerance or hypersensitively at the follow-up assessments. Conclusions:The spiral advancement-transposition flap is suitable for resurfacing pulp defects with excellent functional and high patient satisfaction.