以第一、二掌背动脉为蒂的岛状皮瓣修复拇指套脱伤

目的介绍应用以第一、二掌背动脉为蒂的岛状皮瓣修复拇指套脱伤的临床疗效。方法选择9例拇指套脱伤而指血管神经束、甲根、甲床完好或可修复的患者，采用以第一、二掌背动脉为蒂的手背桡侧岛状皮瓣转移修复拇指。结果术后9例皮瓣及供区植皮全部存活。术后7例获得6个月-4年的随访，2例失访。修复后的拇指及指甲外形、供区皮肤外形均较满意，指甲生长正常，拇指对指功能正常。皮瓣两点分辨觉为6．9mm，平均8mm。结论对拇指套脱伤指血管神经束存在，甲根、甲床尚好或可以修复的患者，采用以第一、二掌背动脉为蒂的手背桡侧岛状皮瓣修复是一种疗效较好的手术选择。

Repair of thumb degloving injuries by island flaps with pedicle of the first or second dorsal metacarpal artery

Objective To introduce the method of repairing thumb degloving injuries by island flaps with pedicle of the first or second dorsal metacarpal artery. Methods Nine thumbs of degloving injuries with intact neurovascular bundle and nail beds were treated by island flaps with pedicle the of first or second metacarpal artery. Results All 9 island flaps survived. Seven cases were followed-up for 6 months to 4 years. The repaired thumbs, reconstructed nail grooves and nail folds, and donor sites all had satisfactory appearance. Nail growth was normal. Two-point discrimination ranged from 6 to 9 mm with an average of 8 mm. Flexion and extension of the thumb, index and middle fingers was normal. Retrieved to primary jobs. Conclusion Island flap based on pedicle of the first or second metacarpal artery is a good choice for treating degloving injuries of the thumb when the neurovascular bundle and nail bed is intact.