吻合血管的骨间背皮瓣移植修复手指皮肤缺损

目的游离长蒂骨间背侧穿支感觉皮瓣修复手指皮肤缺损。方法急诊或择期行同侧骨问背侧穿支感觉皮瓣修复手指皮肤缺损8例；其中单纯皮肤缺损4例，各关节主及被动活动正常；合并肌腱伤或骨折者4例，关节主动活动有不同程度影响。皮瓣大小：3、5cm×2cm～5cm×3cm；端端吻合骨间背侧动脉-指固有动脉，伴行静脉-指掌侧浅静脉，前臂后侧皮神经-指固有神经。术后定期测量两点辨别觉、外观满意度及关节活动度，评估手术效果。结果本组皮瓣全部存活，无1例发生血管危象，两点辨别觉8～18mm。外观满意度评估优5例，良3例。结论长蒂骨间背侧穿支感觉皮瓣是修复手指尤其是指端及指腹皮肤软组织缺损的一种较好方法。

Free posterior osteosseous perforating neurocutaneous flap with extended pedicle transfers for reconstruction of finger defects

Objective To investigate the feasibility of transferring the free posterior interosseous perforating neurocutaneous flap with extended pedicle to reconstruct finger defects.Methods Eight patients in whom finger defects were reconstructed with the free posterior interosseous perforating neurocutaneous flap acute or selective from the same forearm of the injured finger.The flap size ranged from 3.5cm ×2cm to 5cm ×3cm.An end-to-end anastomoses was performed between posterior interosseous artery and proper digital artery, its concomitant vein and volar digital vein, posterior antebrachial cutaneous nerve and part of proper digital nerve,respectively. The static twopoint discrimination, cosmetic satisfaction and joint motion were evaluated in the following-up visit. Results All flaps were survived uneventfully. The 2-point discrimination ranged from 8 to 18 ram. Cosmetic evaluation was excellent in 5 cases, good in 3 cases. All passive and active motions of joints were normal in 4 cases with skin .defects only, however, active motions were sacrificed to some extent in 4 cases accompanied with tendon injury or fracture.Conclusion The free posterior interosseous perforating neurocutaneous flap with extended pedicle may become one valuable option as a small flap for soft-tissue defects, especially in fingertip or pulp.