北京大学学报(医学版)
北京大學學報(醫學版)
북경대학학보(의학판)
JOURNAL OF BEIJING MEDICAL UNIVERSITY(HEALTH SCIENCES)
2015年
2期
326-329
,共4页
童德迪%陈山林%荣艳波%吴乐昊%朱珊
童德迪%陳山林%榮豔波%吳樂昊%硃珊
동덕적%진산림%영염파%오악호%주산
拇指%指损伤%趾%外科皮瓣%修复外科手术
拇指%指損傷%趾%外科皮瓣%脩複外科手術
무지%지손상%지%외과피판%수복외과수술
Thumb%Finger injuries%Toes%Surgical flaps%Reconstructive surgical procedures
目的:探讨应用趾腓侧皮瓣修饰性再造拇指指腹缺损的手术方法及操作技巧。方法:2009年1月至2014年1月,对22例22指拇指指腹缺损的患者,应用同侧趾腓侧皮瓣游离移植修饰性再造拇指指腹缺损,其中采用趾-指动脉和趾-指静脉吻合18例,跖背动脉-桡动脉深支和跖背静脉-手背静脉吻合4例,神经修复均为指-趾神经吻合,供区皮肤缺损采用同侧腹股沟全厚皮片游离移植。结果:术后22例趾腓侧皮瓣游离移植均获成功,伤口一期愈合,无皮瓣坏死。随访6~12个月(平均7.6个月),皮瓣外形逼真,罗纹清晰,出汗、感觉恢复良好,两点分辨觉3.0~6.0 mm,平均4.2 mm。供区植皮完全成活,足部外形及功能无明显影响。结论:趾腓侧皮瓣是修饰性再造拇指指腹缺损的首选皮瓣,再造拇指指腹外形及功能接近正常。
目的:探討應用趾腓側皮瓣脩飾性再造拇指指腹缺損的手術方法及操作技巧。方法:2009年1月至2014年1月,對22例22指拇指指腹缺損的患者,應用同側趾腓側皮瓣遊離移植脩飾性再造拇指指腹缺損,其中採用趾-指動脈和趾-指靜脈吻閤18例,蹠揹動脈-橈動脈深支和蹠揹靜脈-手揹靜脈吻閤4例,神經脩複均為指-趾神經吻閤,供區皮膚缺損採用同側腹股溝全厚皮片遊離移植。結果:術後22例趾腓側皮瓣遊離移植均穫成功,傷口一期愈閤,無皮瓣壞死。隨訪6~12箇月(平均7.6箇月),皮瓣外形逼真,囉紋清晰,齣汗、感覺恢複良好,兩點分辨覺3.0~6.0 mm,平均4.2 mm。供區植皮完全成活,足部外形及功能無明顯影響。結論:趾腓側皮瓣是脩飾性再造拇指指腹缺損的首選皮瓣,再造拇指指腹外形及功能接近正常。
목적:탐토응용지비측피판수식성재조무지지복결손적수술방법급조작기교。방법:2009년1월지2014년1월,대22례22지무지지복결손적환자,응용동측지비측피판유리이식수식성재조무지지복결손,기중채용지-지동맥화지-지정맥문합18례,척배동맥-뇨동맥심지화척배정맥-수배정맥문합4례,신경수복균위지-지신경문합,공구피부결손채용동측복고구전후피편유리이식。결과:술후22례지비측피판유리이식균획성공,상구일기유합,무피판배사。수방6~12개월(평균7.6개월),피판외형핍진,라문청석,출한、감각회복량호,량점분변각3.0~6.0 mm,평균4.2 mm。공구식피완전성활,족부외형급공능무명현영향。결론:지비측피판시수식성재조무지지복결손적수선피판,재조무지지복외형급공능접근정상。
Objective:To investigate the validity and the outcome of a new surgery method that utilizes lateral great toe flap to decoratively reconstruct the thumb pulp loss.Methods:From Jan.2009 to Jan. 2014 , 22 cases with unilateral thumb pulp defect were included, for whom, lateral great toe flap was de-ployed to reconstruct the thumb.Blood circulation was re-established by the anastomosis of the digital vessels of toes and fingers in 18 cases, the other 4 cases were conducted by a dorsal metatarsal artery and vein anastomosed to the deep branch of the radial artery and the dorsal metacarpal vein respectively; as for the nerve repair, toe-to-finger digital nerve anastomosis was performed.The donor sites were covered by full-thickness inguinal skin grafts.Results:All the 22 flaps survived without complications.With 6 to 12 months follow-up, the surviving fingers all presented aesthetically pleasant appearance with vivid loops and whorls.Normal functions like sweating were restored as well, and the two-point-discrimination ranged 3.0 to 6.0 mm (4.2 mm in average).The skin grafts to the donor sites healed uneventfully, the appearance and functions of the feet were unaffected.Conclusion: Lateral toe flap should be the first-line choice for reconstructing thumb defect, as it conveniently restores both functions and outlook.