CAJ | 학술논문

目的应用中指近节桡侧指动脉邻指逆行岛状皮瓣修复拇指指端缺损.方法对10例拇指指端缺损患者,以中指近节桡侧指动脉为血管蒂,以带蒂皮瓣的方式进行修复,供区直接闭合.皮瓣内含指固有神经背侧支,在皮瓣转位后将其与拇指指神经断端缝合重建皮瓣感觉.结果所有皮瓣存活良好,创面Ⅰ期愈合.随访时间为3～12个月.指端外观良好,质地柔软,耐磨,无触痛,重建拇指指腹两点分辨觉为4～6mm,供区无明显并发症,指间关节活动正常.根据中华医学会手外科学会上肢部分功能评定试用标准评定:优9例,良1例.结论中指近节桡侧指动脉邻指逆行岛状皮瓣修复拇指指端缺损外形及感觉恢复良好,是一种简单实用的手术方法.
목적 응용중지근절뇨측지동맥린지역행도상피판수복무지지단결손.방법 대10례무지지단결손환자,이중지근절뇨측지동맥위혈관체,이대체피판적방식진행수복,공구직접폐합.피판내함지고유신경배측지,재피판전위후장기여무지지신경단단봉합중건피판감각.결과 소유피판존활량호,창면Ⅰ기유합.수방시간위3～12개월.지단외관량호,질지유연,내마,무촉통,중건무지지복량점분변각위4～6mm,공구무명현병발증,지간관절활동정상.근거중화의학회수외과학회상지부분공능평정시용표준평정:우9례,량1례.결론 중지근절뇨측지동맥린지역행도상피판수복무지지단결손외형급감각회복량호,시일충간단실용적수술방법.
Objective To present the application of a radial digital artery reverse island flap from proximal phalange of the middle finger for repair of fingertip defect of the thumb.Methods Ten cases of fingertip defect of the thumb were treated with this flap that was based on radial digital artery at the proximal phalangeal level of the middle finger.The pedicled flap was transferred to the defect site.The donor site was directly closed.To restore sen.~tion of the flap,the dorsal branch of the proper digital nerve was inclnded in the flap and sutured to the proper digital nerve in the severed thumb stump.Results All the flaps survived completely.Incisions were healed by first intention.The patients were follow-up for 3 to 12 months.The thumbs had good appearance after the reconstruction.The flaps were supple and resistant to wear and tear.There was no touch pain.The two-point discrimination was 4 to 6 mm.There was no complication at the donor site and no limitation in the movement of the interphalangeal joint.According to the functional evaluation criteria of the upper limb issued by the Hand Surgery Society of the Chinese Medical Association,active range of motion was rated as excellent in 9 cases and good in 1 case.Conclusion Transfer of the radial digital artery reverse island flap from proximal phalange of the middle finger to cover defects of the thumb tip can lead to good appearance and sensation.It is a simple and reliable operative method.