摘要
目的探讨携带神经的第一掌背动脉尺侧支皮瓣修复拇指软组织缺损的临床疗效。方法自2019年12月至2020年10月,我们对收治的7例拇指软组织缺损患者,采用携带神经的第一掌背动脉尺侧支皮瓣修复,缺损面积为1.5 cm×2.0 cm~2.5 cm×3.0 cm,皮瓣切取面积为2.0 cm×2.5 cm~2.5 cm×3.5 cm,皮瓣供区应用第二掌背动脉(second dorsal metacarpal artery,SDMA)穿支皮瓣修复。结果术后2例第一掌背动脉尺侧支皮瓣部分坏死,经换药创面愈合,其余5例皮瓣及修复供区的SDMA穿支皮瓣存活良好。术后随访时间为6~15个月,第一掌背动脉尺侧支皮瓣无臃肿,色泽、质地与拇指相似,拇指外形美观。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价拇指功能:优4例,良3例。皮瓣感觉恢复达S2~S4,3例存在异位感觉定位现象。第一掌背动脉尺侧支皮瓣供区外形满意,存在保护性感觉,示指活动不受限,掌背仅遗留线性瘢痕。结论携带神经的第一掌背动脉尺侧支皮瓣修复拇指软组织缺损,术后外形美观,可重建受区感觉功能,是基层医院修复拇指软组织缺损的一种有效方法。
Objective To investigate the clinical efficacy of the first dorsal metacarpal artery ulnar branch flap carrying nerve for repair of thumb soft tissue defects.Methods From December 2019 to October 2020,7 patients with thumb soft tissue defects were treated using the first dorsal metacarpal artery ulnar branch flap carrying nerve.The defect area was 1.5 cm×2.0 cm to 2.5 cm×3.0 cm.The flap area was 2.0 cm×2.5 cm to 2.5 cm×3.5 cm.The donor area of the flap was repaired with the second dorsal metacarpal artery(SDMA)perforator flap.Results After operation,the first dorsal metacarpal artery ulnar branch flap was partially necrotic in 2 cases,and the wound healed after dressing change.The other 5 flaps and SDMA perforator flaps in the donor area survived well.The follow-up time was 6 to 15 months.The first dorsal metacarpal artery ulnar branch flap was not bulky,the color and texture were similar to those of the thumb,and the shape of the thumb was aesthetic.According to the trial standard of upper limb function evaluation issued by Hand Surgery Society of Chinese Medical Association,thumb function was evaluated as excellent in 4 cases and good in 3 cases.The sensory recovery of the flap was S2 to S4,and 3 cases had ectopic sensory localization.The donor area of the first dorsal metacarpal artery ulnar branch flap had a satisfactory shape with protective sensation,the movement of the index finger was not limited,and only linear scar was left on the dorsal hand.Conclusion The first dorsal metacarpal artery ulnar branch flap carrying nerve can repair the thumb soft tissue defects.It has a beautiful appearance and can reconstruct the sensory function of the recipient area.It is an effective method to repair the thumb soft tissue defects in primary hospitals.
作者
龙航
黄银浩
徐佳丽
朱珠
王玉波
陈飞艳
梁文杰
张小林
Long Hang;Huang Yinhao;Xu Jiali;Zhu Zhu;Wang Yubo;Chen Feiyan;Liang Wenjie;Zhang Xiaolin(Department of Hand and Plastic Surgery,the First People′s Hospital of Bijie Municipal,Bijie 551700,China;Department of Dermatology,the First People′s Hospital of Bijie Municipal,Bijie 551700,China;Department of Spinal Surgery,the First People′s Hospital of Bijie Municipal,Bijie 551700,China)
出处
《中华手外科杂志》
CSCD
北大核心
2022年第2期126-129,共4页
Chinese Journal of Hand Surgery
基金
贵州省卫生健康委科学技术基金(gzwjkj2019-1-156)
贵州省毕节市科学技术联合基金(毕科联合字SY[2019]7)。
关键词
拇指
外科皮瓣
第二掌背动脉
软组织缺损
Thumb
Surgical flaps
The second dorsal metacarpal artery
Soft tissue defects
