接合两侧指背神经的指动脉终末背侧皮支皮瓣修复指端缺损

目的探讨接合两侧指背神经的指动脉终末背侧皮支皮瓣修复指端缺损的方法和临床疗效。方法2008年8月-2011年8月．采用接合两侧指背神经的指动脉终末背侧皮支皮瓣修复2～5指指端缺损6例，其中食指2例，中指1例。环指2例，小指1例，皮瓣切取面积最大22mm×20mm，最小10mm×9mm。结果6例6指皮瓣全部成活．术后经6～24个月随访，平均13个月，皮瓣外观及手指功能恢复满意，感觉恢复S3，皮瓣两点辨别觉6～9mm，平均7．6mm，供区无并发症。结论接合两侧指背神经的指动脉终末背侧皮支皮瓣具有血供可靠．不破坏重要血管，且有可供接合的神经，操作简便等优点，是修复手指指端缺损较为理想的方法。

Repair of fingertip defect by anastomosed nervous digital dorsal flaps based on the end dorsal branches of the digital artery

Objective To investigate the therapeutic effect of anastomosed nervous digital dorsal flap based on the end dorsal branches of the digital artery for repairing skin defects at fingertip. Methods From August 2008 to August 2011, 6 cases with skin defects at fingertip were treated with the digital dorsal flaps, including 2 index fingers, 1 middle fingers, 2 ring fingers and 1 litde fingers. The flaps size ranged from 20 mm×18 mm to 22 mm×20 mm. Results 6 flaps in 6 cases survived completely. 6 fingers were followed up for 6-24 months. The aesthetic and functional results were both satisfactory. The flaps sensation was graded as S3, with a discrimination distance of 6-9mm （median, 7.6mm ）. No complication happened in donor sites. Conclusion The anastomosed nervous digital dorsal flap based on the end dorsal branches of the digital artery has reliable blood supply with less morbidity to the main artery. It is safe and easily performed with good effect for fingertip defect.