双蒂掌背动脉逆行皮瓣治疗手指末节脱套伤

目的 探讨双蒂掌背动脉逆行皮瓣治疗手指末节脱套伤的方法.方法 2005年1月至2008年3月,对28例28指末节脱套伤患者,应用双蒂掌背动脉逆行皮瓣修复,其中示指10指,中指13指,环指5指,缺损平面均在远侧指问关节以远,脱套末节长度0.8～2.2 cm.急诊手术24指,末节皮肤坏死二期手术4指.结果 28例28指皮瓣.除3例皮瓣远端部分张力性水泡形成表皮坏死结痴经换药愈合外,余全部成活.25例经4～27个月随访,外形、感觉和功能恢复满意,静态两点辨距觉达6.0～9.0 mm,平均7.6 mm.结论 双蒂掌背动脉逆行皮瓣治疗手指末节脱套伤,手术简便、安全,疗程短,效果满意.

The reverse flap based on two dorsal metacarpal artery for reconstruction of degloved fingertip avulsion

Objective To discuss the application of reverse flap based on two dorsal metacarpal artery for reconstruction of degloved fingertip avulsion.Methods From Jan.2005 to Mar.2008,28 cases with degloved fingertip avulsion were treated with reverse flaps based on two dorsal metacarpal artery.The defects were located distal to the distant interphalangeal joints and were 0.8-2.2 cm in length.10 defects was in the index fingers,13 in the middle fingers and 5 in the ring fingers.24 fingers were treated in an emergency surgery.4 fingers were treated due to skin necrosis.Results Epidermal necrosis happened at the distal end of flaps in 3 cases.All the other flaps survived completely.25 cases were followed up for 4-27 months with satisfactory cosmetic and functional results.The 2-points discrimination distance was 6.0-9.0 mm(average,7.6 mm).Conclusions The reverse flap based on two dorsal metacarpal artery is easily perfomed and reliable for dagloved fingertip avulsion with satisfactory results.