摘要
目的分析两种手指逆行岛状皮瓣修复指远节软组织缺损的临床效果的异同、适应证和注意事项。方法从2000年1月至2008年7月，共收治500例514指远节软组织缺损．按照缺损面积分别采用同指侧方逆行岛状皮瓣（250例263指）和邻指侧方逆行岛状皮瓣（250例251指）修复。术后随访3～8年，比较两种皮瓣的修复范围、指蹼开大角度、皮瓣感觉等。结果500例514指皮瓣全部成活，术后随访按照皮瓣修复范围比较，邻指皮瓣（2．5cm×5．0cm）优于同指皮瓣（2．0cm×3．0cm）（P〈0．05）；按照指蹼开大角度（大于或等于30°）比较，同指皮瓣（229指）优于邻指皮瓣（166指）（P〈0．05）；同指皮瓣的感觉恢复略好于邻指皮瓣（P〈0．05）；按照远期效果比较，两者差异无统计学意义（P〉0．05）。结论在手指远节小于2．0cm×2．5cm软组织缺损。可选用同指皮瓣；超过2．0cm×3．0cm软组织缺损，应选用邻指皮瓣。依据皮瓣修复面积首选邻指皮瓣：依据指蹼开大和感觉恢复首选同指皮瓣；依据手指灵活性。两种皮瓣均可。
Objective To analysis the clinic outcome （similarities ＆ differences, indication and caution） of repairing fingertip soft tissue defect with two kind of reverse digital artery island flaps with the palmar cutaneous branch of proper digital nerve. Methods From January 2000 to Auguest 2008, all 500 cases （514 fingers） were repaired with reverse homodigital artery island flap （263 fingers of 250 cases） and reverse cross finger digital artery island flap（251 fingers of 250 cases）. All cases were followed up from 3-8 years, compared with flap range, finger extension, sensory rehabilitation, et al. Results All flaps （A ＆ B group） of 500 cases （514 fingers） survived. According to flap range, cross finger flap was better than homodigital flap （P 〈 0.05）; according to finger extension, homodigital flap better than cross finger flap （P 〈 0.05）; according to sensory rehabilitation, homodigital flap little better than cross finger flap （P 〈 0.05）; according to long-term follow-up, all had no obviously different （P 〉 0.05）. Conclusion Homodigital flap can cover distal soft tissue defect less than 2.0 cm × 2.5 cm, cross finger flap is a better choice for more than 2.0cm×3.0cm of distal soft tissue defect. According to the flap cover area, cross finger flap is first choice, and to finger extension ＆ sensory rehabilitation, homodigital flap is first choice; accoding to finger movements, two kinds of flaps are all good choice.
出处
《中华显微外科杂志》
CSCD
北大核心
2012年第2期132-134,共3页
Chinese Journal of Microsurgery
关键词
同指皮瓣
邻指皮瓣
岛状皮瓣
指
显微外科
Homodigital flap
Cross finger flap
Island flaps
Finger
Microsurgery
