摘要
目的探讨吻合趾背神经的第2足趾胫侧皮瓣修复手指指端缺损的方法和效果。方法对13例指端缺损，应用吻合趾背神经的第2足趾胫侧皮瓣游离移植修复指端缺损。皮肤软组织缺损面积2．5cm×1．5cm-1．3cm×1．0cm，皮瓣切取面积2．7cm×1．7cm-1．5cmX1．1cm。皮瓣供区移植全厚皮片。结果术后皮瓣及植皮全部成活。随访6-18个月，平均13个月，手指外观良好、感觉恢复较好，皮瓣静态两点辨距觉为7-13mm，平均9mm。根据关节总活动度法评定手功能：优11指，良1指，可1指。依据Michigan手部功能问卷评定标准对患指外观满意度进行评价，10例非常满意，3例满意。皮瓣供区愈合良好，第2足趾趾腹饱满，趾腹的静态两点辨距觉为6-10mm，平均为8mm。结论应用保留趾底固有神经，吻合趾背神经的第2足趾胫侧皮瓣在修复手指指端软组织缺损的同时减少了对供区的损伤，是修复指端皮肤软组织缺损的一种较好的术式。
Objective To report the operation methods and clinical effects of repairing finger tip defect with the free tibial dorsal nerve flap of the second toe. Methods 13 patients with finger tip defects were repaired by the tibia] dorsal nerve flap of the second toe. The area of finger tip defect was 2.5 cmx 1.5 cm - 1.3 cm x 1.0 cm, and the area of cutting flap was 2.7 cm x 1.7 cm - 1.5 cm ~ 1.1 era. All donor site defects on the second toe were covered with full-thickness skin graft. Results There were 13 cases in this group, and all the flaps and skin grafts were survived. Postoperative follow-up ranged from 6 to 18 months, with an average of 13 months. The appearance of the fingers was satisfied and the sensory recovery was good. Two-point discrimination of the flaps returned to 7 - 13 mm, with an average of 9 mm. According to the total active move（TAM） scale, results were excellent in 11 fingers, good in 1 finger, and fair in 1 finger. The donor site skin graft was well healed, the second toe pulp was full, and the two-point discrimination of the toe pulps were 6 - 10 mm, with an average of 8 mm. Conclusions Compared to the traditional method of repairing finger tip defect with the tibia] inherent nerve flap of the second toe, our new method can reduce the damage to the donor site, and we can repair finger tip defect as well as the traditional one at the same time. So it was a better operative method to repair finger tip defect with the tibial dorsal nerve flap of the second toe.
作者
蒋国栋
巨积辉
吕文涛
刘新益
李友
刘海亮
周广良
侯瑞兴
王晓松
Jiang Guodong;Ju Jihui;Lyu Wentao;Liu Xinyi;Li You;Liu Hailiang;Zhou Guangliang;Hou Ruixing;Wang XiaoSong(Department of Hand Surgery,Affiliated Ruihua Hospital of Soochow University,Suzhou 215104,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2018年第7期515-519,共5页
Chinese Journal of Plastic Surgery
基金
江苏省自然科学基金项目（BK20151203）
江苏省青年医学人才项目（QNRC2016224）
关键词
指损伤
外科皮瓣
趾背神经
趾
Finger injuries
Surgical flap
Dorsal nerve
Toes
