| 皮瓣移植修复手指近中节软组织缺损的疗效观察 |
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Received:June 20, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 吴双军 |
WU Shuang-jun |
杭州市西溪医院骨科, 浙江 杭州 310023 |
Depatment of Orthopedics, Xixi Hospital of Hangzhou City, Hangzhou 310023, Zhejiang, China |
xszyy168@163.com |
| 赵明兴 |
ZHAO Ming-xing |
杭州市西溪医院骨科, 浙江 杭州 310023 |
Depatment of Orthopedics, Xixi Hospital of Hangzhou City, Hangzhou 310023, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年29卷，第11期，第1053-1057页 |
| DOI：10.3969/j.issn.1003-0034.2016.11.016 |
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目的：探讨3种不同类型皮瓣移植修复手指近、中节软组织缺损的手术方法及疗效。
方法：自2011年5月至2015年5月，应用3种不同类型皮瓣移植修复近中节手指软组织缺损102例115指，男59例70指，女43例45指；年龄19~62岁，平均45.6岁。其中游离腓动脉穿支皮瓣修复29例29指、游离尺动脉腕上穿支皮瓣35例37指、掌背动脉穿支逆行筋膜皮瓣修复38例49指。软组织缺损面积1.8 cm×4.0 cm~2.8 cm×5.4 cm.皮瓣切取面积2.0 cm×4.4 cm~3.1 cm×6.0 cm.术后从皮瓣成活率、手指功能及并发症等方面进行评价手术疗效。
结果：皮瓣全部存活，其中5例出现皮瓣远端表皮坏死，经创面换药治疗后愈合。供、受区未并发深部感染。其中有3例皮瓣供区出现植皮部分坏死，经换药治疗后延期愈合。所有患者获随访，时间6~28个月，平均10.6个月，皮瓣外形及质地良好，皮瓣感觉功能恢复良好，两点分辨觉为9~13 mm；供区无明显功能障碍。手指关节功能：优52例，良41，中9例。
结论：对于手指近中节软组织缺损的修复，应根据患者性别和年龄差异、缺损创面情况、术者对手术方法的掌握程度以及医院技术条件等方面来选择合适的皮瓣。 |
| [关键词]:外科皮瓣 软组织损伤 手指损伤 外科手术 |
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| Repair of the finger proximal and middle segment soft tissue defect with flap transplantation |
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Abstract:
Objective: To summarize and analyze the surgical methods and therapeutic effects of repair of the finger proximal and middle segment soft tissue defect with three different types of skin flaps.
Methods: From May 2011 to May 2015,102 patients with 115 fingers proximal and middle segment soft tissue defect underwent reconstruction with three different types of skin flaps. There were 59 males with 70 fingers and 43 females with 45 fingers,aged from 19 to 62 years old with an average of 45.6 years. Twenty-nine patients with 29 fingers were repaired by free peroneal artery perforator flaps,35 patients with 37 fingers were repaired by the free vascularized flaps based on the wrist cutaneous branch of ulnar artery,38 patients with 49 fingers were repaired by metacarpal dorsal artery perforator flaps. The soft tissue defect area varied from 1.8 cm×4.0 cm to 2.8 cm×5.4 cm. The flap area varied from 2.0 cm×4.4 cm to 3.1 cm×6.0 cm. The clinical results were evaluated based on flap survival rate,finger function and complications.
Results: All flaps survived. Distal skin flap necrosis occurred in 5 flaps,but healed after wound dressing therapy. No deep infection were found in donor site and recipient site. There were 3 cases with partial necrosis of the skin graft,and delayed healing after wound dressing therapy. All patients were followed up from 6 to 28 months with an average of 10.6 months. The appearance and texture of flaps were well. The sensation were good,two-point discrimination was 9 to 13 mm. There were no obvious dysfunction happened in the donor site. The function of the fingers was excellent in 52 cases,good in 41,fair in 9 cases.
Conclusion: About the repair of the finger proximal and middle segment soft tissue defect,the right flap should be choosen based on the difference of the sex and the age in patients,wounds situation,the master degree of the operation method and the hospital's technical conditions. |
| KEYWORDS:Surgical flaps Soft tissue injuries Finger injuries Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴双军,赵明兴.皮瓣移植修复手指近中节软组织缺损的疗效观察[J].中国骨伤,2016,29(11):1053~1057 |
| 英文格式: | WU Shuang-jun,ZHAO Ming-xing.Repair of the finger proximal and middle segment soft tissue defect with flap transplantation[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(11):1053~1057 |
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