摘要
目的探讨通过缝合神经重建感觉的桡背侧皮神经营养“M”形皮瓣修复拇指末节套脱伤的临床效果。方法自2013年6月至2014年3月，对9例拇指末节套脱伤患者，采用指背神经与指神经缝合重建感觉的拇指桡背侧皮神经营养“M”形皮瓣修复。结果9例患者术后均获得随访，时间6～12个月，皮瓣全部顺利存活，蒂部无臃肿，质地柔软，外观满意，颜色与周围皮肤接近，两点分辨觉为7—10mm，拇指术后各关节活动正常。手功能按手指关节总活动度（TAM）法评定：优7指，良2指。供区无并发症。结论该术式不损伤指动脉和指神经，通过缝合指背神经重建皮瓣的感觉，是修复拇指末节套脱伤较为理想的手术方法。
Objective To investigate the clinical results of repairing thumb tip defect caused by degloving injury with M-shaped dorsal radial neurocutaneous flap which is made sensate by nerve coaptation. Methods From June 2013 to March 2014, 9 cases with thumb tip degloving injury were treated. Using the thumb and finger dorsal nerve sensory nerve anastomosis radial M-shaped dorsal radial neurocutaneous flap was transferred to cover the defect. The dorsal cutaneous nerve was coapted with the proper digital nerve to restore sensation of the flap/thumb tip. Results All 9 flaps survived completely uneventfully. All the patients were follow-up for 6 to 12 months. The color, texture and contour of the flaps were good. Two-point discrimination was 7 to 10 mm on the flap. Joint movement of the thumb was normal. Hand function was assessed by total active motion （TAM） and was rated as excellent in 7 thumbs and good in 2 thumbs. There was no complication in the donor site. Conclusion This procedure spares the proper digital artery and nerve. Flap sensation is restored by suturing the dorsal cutaneous nerve branch. The operative procedure is an ideal method for the treatment of thumb tip degloving injury.
出处
《中华手外科杂志》
CSCD
北大核心
2015年第6期421-423,共3页
Chinese Journal of Hand Surgery
关键词
拇指
外科皮瓣
修复
Thumb
Surgical flaps
Repair
