| 指腹缺损的显微外科再造 |
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Received:January 26, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 赵亮 |
ZHAO Liang |
济南市第三人民医院手外科中心,山东济南250101 |
The Center of Hand Surgery,the Third Hospital of Jinan,Jinan Shandong,250101,China |
workhard1974@sohu.com.cn |
| 徐有静 |
XU You-jing |
济南市第三人民医院手外科中心,山东济南250101 |
The Center of Hand Surgery,the Third Hospital of Jinan,Jinan Shandong,250101,China |
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| 王鑫 |
WANG Xin |
济南市第三人民医院手外科中心,山东济南250101 |
The Center of Hand Surgery,the Third Hospital of Jinan,Jinan Shandong,250101,China |
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| 王文德 |
WANG Wen-de |
济南市第三人民医院手外科中心,山东济南250101 |
The Center of Hand Surgery,the Third Hospital of Jinan,Jinan Shandong,250101,China |
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| 吴德富 |
WU De-fu |
济南市第三人民医院手外科中心,山东济南250101 |
The Center of Hand Surgery,the Third Hospital of Jinan,Jinan Shandong,250101,China |
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| 赵风林 |
ZHAO Feng-lin |
济南市第三人民医院手外科中心,山东济南250101 |
The Center of Hand Surgery,the Third Hospital of Jinan,Jinan Shandong,250101,China |
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| 期刊信息：《中国骨伤》2005年18卷，第8期，第454-455页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:总结手指指腹缺损的显微外科再造方法及其疗效。
方法:根据手指指腹缺损的面积及软组织损伤的部位,对40例62指指腹缺损的创面采用改良指动脉岛状皮瓣、指固有血管神经蒂指背皮瓣、游离趾腹皮瓣进行修复,同时重建患指的感觉。其中机器绞伤19例,挤压伤15例,切割伤6例,均为手指指腹缺损并骨质或肌腱外露;拇指8指,示指19指,中指16指,环指12指,小指7指,皮瓣切取面积1.5cm×1.5cm～4.0cm×2.2cm,改良指动脉岛状皮瓣38指,指固有血管神经蒂指背皮瓣15指,游离趾腹皮瓣9指。
结果:40例62指皮瓣完全成活,4指皮瓣发生血管危象,经换药及手术探查,危象解除。全部病例随访6个月～2年,指腹两点辨别觉5～10mm,指间关节屈伸自如,外观饱满,质地柔软,弹性好。手功能按TAM法评定,优25指,良30指,可7指。
结论:采用改良指动脉岛状皮瓣、指固有血管神经蒂指背皮瓣、游离趾腹皮瓣再造手指指腹是较理想的方法。 |
| [关键词]:显微外科手术 修复外科手术 指损伤 皮瓣 |
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| Microsurgical reconstruction of digit tip defect |
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Abstract:
Objective:To summarize the method and outcome of microsurgical reconstruction in digit tip defect.
Methods:Sixty-two digits of 40 patients were treated by the improved island flap of digit artery,neurovascular flap of digital dorsal and free flap of the big toe at the fibular lateral side;Meanwhile the sensation of the affected digits were reconstructed according to the size of the digits tip defect and the location of the soft tissue defect of hands.Among 40 cases,twist by machines was found in 19 cases,squeeze in 15 cases,cut-injuries in 6 cases.All the cases suffered from the digit tip defect with exposing bone or ligament.The affected digits were:8 thumbs,19 forefingers,16 middle fingers,12 ring fingers and 7 little fingers;Area of flaps was 1.5 cm×1.5 cm～4.0 cm×2.2 cm.Improved island flap of digit artery was used for 38 digits,neurovascular flap of digital dorsal for 15 digits and free flap of the big toe at the fibular lateral side for 9 digits.
Results:The flaps of all the cases survived completely.Vessel crisis occurred in 4 flaps,but was removed by dressing change and operative exploration.All cases were followed up from 6 months to 2 years,two-points discrimination was 5～10 mm,good finger motion was obtained,appearance and function were satisfactory.According to the TAM criteria,the results were excellent in 25 digits,good in 30,fair in 7.
Conclusion:Using improved island flap of digit artery,neurovascular flap of digital dorsal and free flap of the big toe at the fibular lateral side are valuable methods in the digit tip reconstruction. |
| KEYWORDS:Microsurgery Reconstructive surgical procedures Finger injuries Skin flap |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 赵亮,徐有静,王鑫,王文德,吴德富,赵风林.指腹缺损的显微外科再造[J].中国骨伤,2005,18(8):454~455 |
| 英文格式: | ZHAO Liang,XU You-jing,WANG Xin,WANG Wen-de,WU De-fu,ZHAO Feng-lin.Microsurgical reconstruction of digit tip defect[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(8):454~455 |
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