指背血管蒂岛状皮瓣修复拇指组织缺损

目的 探讨拇指组织缺损的修复方法。方法 利用8具尸体16只手进行解剖学研究，观察了拇指背动脉、第1掌背动脉及食指桡侧指背动脉。临床上分别以拇指背动脉、示指桡侧指背动脉为蒂于手背侧设计岛状皮瓣进行应用。结果 拇指背动脉外径0．24～0．46mm，平均0．37mm，示指桡侧指背动脉0．26～0．56mm，平均0．44mm，血管恒定。临床应用拇指背血管蒂逆行皮瓣、示指桡侧指背血管蒂皮瓣修复拇指组织缺损12例；皮瓣带人桡神经指背支形成有感觉皮瓣，效果更满意。结论 以指背血管为蒂的手背侧皮瓣是修复拇指组织缺损的较为理想方法。

Vascular basis and clinical application of dorsal digital flaps for covering thumb soft tissue defects

Objective To investigate method for repairing the skin and soft tissue defects in the thumb. Methods Eight adult cadavers ( 16 hands) were used to stud) dorsal artery of thumb, Ist dorsal metacarpal arterv and dorsal artery of radial lateral in index finger. On the basis of the author' s anatomical study, island flaps were planned on the dorsum of the thumb or the index finger with dorsal artery of thumb. dorsal artery of radial lateral in index linger respective for clinical application. Results The diameter of the dorsal artery of the thumb was 0. 24 mm to 0. 46 mm.0. 37 mm in average. The diameter of the dorsal artery of radial lateral in index finger was 0. 26 mm to 0. 56 min.0. 44 mm n average. 12 cases with soft tissue defects in thumbs were repaired with reversed island flap pedieled with dorsal artery of thumb and island flap pedicled with dorsal artery of radial lateral in index finger. Innervation was achieved in all patients who under went sensory flap transfer, as indicated by 4 mm ol two-point discrimination in four weeks postoperation. Conclusion Island flap on the dorsum of the finger, pedicled with the dorsal vessels,seems to be an excellent option for one-stage reconstruction of the soft tissue defect in the thumb with very favourable functional and cosmetic results